Techniques are provided for detecting stroke within a patient using an implantable medical device in conjunction with an external confirmation system. In one example, a preliminary detection of stroke is performed by a subcutaneous monitor based on an analysis of features of an electrocardiogram (ECG) sensed within the patient. Exemplary ECG features indicative of possible stroke include the onset of prominent U-waves, the onset of notched T-waves, and changes in ST segment duration or QT duration or dynamic trends in these parameters. The monitor transmits a signal indicative of possible stroke to a bedside monitor or other external system, which generates a stroke questionnaire for use in confirming the stroke. Family members or other caregivers input answers to the questionnaire into the external system, which confirms or disconfirms the stroke. Emergency personnel can be automatically notified. Implantable systems that detect stroke based on intracardiac electrogram (IEGM) signals are also described herein.