Medical Procedures/Testing for Neurological Dysfunction Flashcards
What is a ventriculography?
X-rays of the skull after injection of air into the lateral ventricles
Helps localize tumors
What is a myelography? Complications?
X-rays of the spine after injection of air or dye into the subarachnoid space
Delineates abnormalities impinging the subarachnoid space
Complications = dye may result in headaches or meningeal irritation
What is a cerebral angiography? Complications?
X-rays of the skull after injection of dye into carotid or the vertebral arteries or both
Delineates potential CVA, brain tumor, aneurysm or vascular malformation
Complications = may cause meningeal irritation, hemorrhage, vasospasm, or anaphylactic reaction to dye
What is a CT scan?
Brain scan imaging that provides cross sections of the area tested with precise 2D/3D views of bones, tissues and organs.
Delineates potential brain abnormalities, cerebral edema, hemorrhage, stroke, infarction
How can a CT scan be useful in cases of acute stroke?
Allows for administration of TPA in absence of evidence of hemorrhage within 3 to 4.5 hours of thromboembolic stroke
What is an MRI? Contraindications?
Brain imaging that is non-invasive and does not use radiation. Dye can be added to enhance view of certain tissue.
Rules out tumors, MS and head trauma. Provides resolution of tissues but bone is poorly imaged.
Contraindications = metal implants and pacemakers.
What is positron emission tomography (PET)?
Neuroimaging technique in which radioisotopes are inhaled or injected to produce 3D images of brain activity.
Delineates cerebral blood flow and brain metabolism
What is an electroencephalography (EEG)?
Noninvasive procedure that can continuously measure electrical activity of the brain using multiple electrodes attached to the skull
Used to rule out seizures and assist in localization of intracranial lesions in the brain
What are evoked potentials?
Non-invasive procedure using two sets of electrodes that records the time takes for an impulse to reach the brain. External stimuli (auditory, visual, proprioceptive) are used to evoke electrical potentials within the brain.
Detects lesions if responses are delayed or absent, MS, SCI, and acoustic neuromas.
What is an encephalogram?
Ultrasound/doppler technique where waves are recorded and analyzed
Useful for imaging the carotid artery and analyzing flow, detection of plaques in carotid artery
What is a lumbar puncture? Complications?
Insertion of a spinal needle below the level of L1-L2 (most commonly performed at the L3-L4 level) for CSF sample
Used to rule out hemorrhage, inflammation, infection, meningitis and tumor
Complications = severe headache due to CSF leakage (relieved by lying down), infection, epidural hematoma, uncal herniation
What is the normal appearance, volume, pressure and protein content of CSF?
Appearance = crystal clear and colorless Volume = 90-150 mL (adult); 60-100mL (child) Pressure = 90-180 mm H2O (adult); 10-100 mm H2O (child) Protein = 15-45 mg/dL (adults); 15-100 mg/dL (neonates)
What may RBCs, WBCs and elevated protein content in CSF indicate?
RBCs = hemorrhage or traumatic tap WBCs= significant inflammation and infection Protein = tumors or inflammation
What is an electromyelography (EMG)?
Detects electrical activity arising from muscles, both resting and active contraction
Useful in diagnosing LMN disease or denervated muscle disease
What is nerve conduction velocity testing?
Non-invasive stimulation of a peripheral nerve to determine the nerves action potentials and the nerve’s ability to send a signal
Rules out peripheral neuropathies, carpal tunnel syndrome, demyelination pathology, and peripheral nerve compression
