The evaluation of aphasia begins with a medical history and physical examination.

The diagnosis of aphasia can be made without testing, but testing is required to determine the underlying cause for aphasia.

Tests for aphasia may include:

• CT scanning of the brain
• MRI scan of the brain
• SPECT scanning:
• A newer method that may provide earlier detection of stroke in some cases
• PET scanning of the brain:
• Can detect changes in brain metabolism and activity.
• Blood clotting studies
• Electrocardiogram
• Blood electrolytes
• Blood glucose
• Pulse oximetry
• EEG

Other tests that may be required if a stroke or TIA is the cause for the aphasia:

• Carotid angiogram:
• A special x-ray procedure that can detect blood vessel narrowing in the carotid arteries, which often cause strokes.
• Carotid duplex ultrasound, or doppler ultrasound:
• Can detect narrowing and reduced blood flow in the carotid arteries that supply the brain
• C-reactive protein
• Coagulation profile and bleeding time
• Homocysteine level
• LDL level
• HDL level
• VLDL level
• Total cholesterol level
• Lp-PLA2:
• Often elevated in people who are at high risk for stroke