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UNCG - Speech and Hearing Neurology
KYNDALL ALLRED
ALEXA DAVIS
JULIE HURD
KAYLA LOFLIN
Brain Diagnostic Testing:
Overview
Watch this video to learn the basics of Brain Diagnostic Testing:
What is Brain Diagnostic
Testing?
• A vital tool that helps confirm or rule out the
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presence of a neurological disorder or other
medical conditions
Allows physicians to simultaneously see the
structure of the brain & the changes in brain
activity as they occur
The most common are: MRI & CT Scans
Types of Neuro Diagnostic
Tests:
• Angiography: a test used
to detect blockages
of the arteries or veins
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Biopsy: a test that
involves the removal
and examination of
tissue from the body
Picture of an Angiography
Types of Neuro Diagnostic
Tests:
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Brain Scan: imaging techniques used to diagnose
tumors, blood vessel malformations, or hemorrhage in
the brain
Cerebral Spinal Fluid Analysis: removal of a small
amount of the fluid that protects the brain and spinal
cord
Computed Tomography (CT Scan):
noninvasive, painless process used to produce rapid,
clear two-dimensional images of organs, bones, and
tissues
o yields a three-dimensional image of the brain
o CT uses an x-ray beam that is passed through the brain
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Types of Neuro Diagnostic
Tests:
• Discography: suggested for patients who are
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considering llumar surgery, or whose lower
back pain has not responded to conventional
treatments
Electroencephalography (EEG):
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monitors brain activity through the skull
EEG is used to help diagnose certain seizure
disorders, brain tumors, brain damage from head
injuries, inflammation of the brain and/or spinal cord,
and degenerative disorders that affects the brain
Types of Neuro Diagnostic
Tests:
• Electromyography (EMG): used to diagnose
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nerve and muscle dysfunction and spinal cord
disease
Electronystagmography (ENG): describes a
group of tests used to diagnose involuntary eye
movement, dizziness, and balance disorders
o also evaluates some brain functions
Positron Emission Tomography (PET): visual
technique where the subject is given radioactive
form of glucose
Types of Neuro Diagnostic
Tests:
• Functional MRI (fMRI): a form of magnetic
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resonance imaging of the brain that registers
blood flow to functioning areas of the brain
Regional Cerebral Blood Flow
Magnetoencephalograph: a technique for
mapping brain activity by recording magnetic
fields produced by electrical currents
occurring naturally in the brain, using very
sensitive magnetometers.
Types of Neuro Diagnostic
Tests:
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Single Photon Emission Tomography (SPECT):
integrates two technologies to view your body:
combination of a CT and a radioactive material
(tracer)
o the tracer is what allows doctors to see how
blood flows to tissues and organs
Fluoroscopy: type of x-ray with low dose of
radiation
o evaluates blood flow
Polysonogram: a multiparametric test used in the
study of sleep.
Types of Neuro Diagnostic
Tests:
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Magnetic Resonance Imaging (MRI): uses
computer-generated radio waves and a
powerful magnetic field to produce detailed
images of body structures including tissues,
organs, bones, and nerves.
allows views of multiple slices of the brain
o most widely used diagnostic imaging technique in
neurology
o very sensitive to abnormalities
o generates cross-sectional image by using radio waves
and a strong magnetic field to detect the distribution of
water molecules in living tissue
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Types of Neuro Diagnostic
Tests:
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Thermography: uses an infrared thermometer to detect
temperature changes in your skin, usually between two
extremities
Cranial Ultrasound:
o Head Ultrasound: produces images of the brain and the
cerebrospinal fluid
 mostly used on infants and babies
o Transcranial Doppler (TCD): evaluates both the direction
and velocity of the blood flow in the major cerebral
arteries of the brain.
 Usually used during surgical procedures to monitor
blood flow in the brain
 Also can be used with MRI, MRA, and CT scans
ADVANCES IN
NEUROSURGERY
WATCH THIS VIDEO TO LISTEN TO A BRIEF OVERVIEW OF
IMPROVEMENTS AND ADVANCES IN NEUROSURGERY
Frameless Stereotaxy
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Mathematical discipline
Calculates angles and distances
from outside of the skull to a
point within the brain
Helps surgeons navigate safely
through high risk areas of the
skull and brain
http://216.31.180.7/old%20files/pages/practiceframeless.ht
Allows neurosurgeons to know whereml he or she is in the brain
at all times.
Neurosurgeons can confidently undergo complex surgical
approaches through the base of the skull.
Telemedicine
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Internet link of surgery
Princeton University can do video conferencing of
microscopic surgeries and advise neurosurgeons of remote
areas.
Use of image guidance and
optical cameras.
Providing advanced neurosurgery
to remote areas such as
Tanzania, Africa
X-Knife Radiosurgery
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For brain lesions
Vital technology for destroying
intracranial metastatic tumors
and benign tumors.
Non coplanar arcs are used to
target a lesion established by
CT scans.
Allow accurate destruction and
avoids surrounding structures.
No immediate side effects.
READ: Northwestern Memorial Hospital, the
only academic medical center in Chicago to
offer Gamma Knife radiosurgery, has
enhanced its radiosurgery program by
upgrading to the most sophisticated
equipment available for treating cancerous
tumors and lesions.
Ultrasound Guided
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Ultrasound guided chiari
malformation surgery
Ultrasound guided Chiari
malformation surgery - defects of
cerebellum.
Neurosurgeons are using
ultrasound to guide the operation.
It gives the surgeon the ability to
monitor the patient’s condition in
real time and decrease risks to the
patient.
Spinal Cord Monitoring
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Surgeons choose to monitor
the a MEP, EMG and nerve
action portals during surgery.
It allows the surgeon to remove
bone fragments, tumors and
substances while keeping track
of the nerve conditions.
The process immediately alerts
the neurosurgeon to potential
complications.
Balloon Technology
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Balloon manufactured by Kyphon
For vertebral compression fractures.
One or 2 small incisions are made in the
back, a catheter with a balloon called
KyphX Inflatable Bone Tamp is passed into
fractured vertebrae under x-ray guidance.
After the balloon expands, plastic cement is
injected into the cavity to stability the bone
and relieve pain.
Balloon Technology (cont.)
Illustration of the intra-aneurysmal balloon-assisted coiling technique. (a) Inflated
Hyperform balloon at the entrance of the larger distal aneurysmal lobule, limiting
coiling to the proximal lobule. (b) A Hyperglide balloon is inflated across the
aneurysm neck as the deflated intra-aneurysmal balloon is slowly removed to
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prevent coil mass disturbance
Stereotactic Surgery
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Minimally invasive surgery
Provides extreme accuracy
There is a computerized link
between a CT Scan or MRI
to the equipment
Neurosurgeons can
precisely place a needle into
a very small lesion or tumor
with an accuracy of one
millimeter
TO LEARN MORE
ABOUT STEREOTACTIC
SURGERY - CLICK ON
THIS LINK
WATCH A VIDEO GUIDE
TO STEREOTACTIC
SURGERY
Open Microneurosurgery
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For brain aneurysms
Also called “clipping”
Patients under general anesthesia, an incision is made on
the head and a window is made in the bone of the skull
The surgeon then uses a microscope to place a platinum
clip on the neck of the aneurysm, isolating it from the
normal vessel
The aneurysm is typically cured and the risk of subsequent
re-bleeding is minimized
In the case of an unruptured aneurysm, most patients are
out of bed within a day or two of surgery
Endovascular Surgery for Brain
Aneurysms
• Minimally-invasive, endovascular method of treating
aneurysms
• In the endovascular technique, the patient is placed under
general anesthesia and a catheter is inserted into an artery in
the groin and brought up into the blood vessels of the brain.
• Images are then taken of the vessels of the brain to identify
the aneurysm.
• Next, a smaller micro-catheter is
then placed in the aneurysm
and the aneurysm is filled with
detachable coils, causing the
aneurysm to be obliterated
Hemicrainectomy
In the News: GABRIELLE GIFFORD'S SURGERY
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when a piece of the skull is removed to allow for brain
swelling
the flap of bone that is removed was once a critical
protective plate for the brain
WATCH THIS VIDEO:
Hemicrainectomy (cont.)
of a
hemicraniectomy
READ THIS ARTICLE:
THANK YOU
We hope that this presentation has
helped to increase your knowledge on
Brain Diagnostic Testing and
Advances in Neurosurgery!