From this article you will learn: how to check the vessels of the brain and neck, when it is necessary to undergo examinations, how they pass and how long they take. Who can recommend such procedures.
content of the article:
- Age features research
- What abnormalities can be detected
- ultrasound
- Rheoencephalography( REG)
- Electroencephalography( EEG)
- angiography( X-ray, CT, MRI)
- Radionuclide( Isotope) methods
- Conclusion
Check the brain vascular system and neckoften prescribed by doctors of many specialties. Recommended for such a survey for many reasons, the main ones are presented in the table:
| Presence of symptoms | Frequent, persistent or growing headache Violations and loss of sight, hearing, speech Broken attention, forgetfulness, memory loss Changes in coordination of movements Convulsive syndrome "Flies"Before the eyes, unconscious and pre-occult states Persistent increase or decrease in intracranial and / or arterial pressure |
|---|---|
| Pathology | Traumatic( _ All strokes and transient attacks Inflammatory pathologies of the brain, its membranes( encephalitis, meningitis) Atherosclerotic vascular lesions Arterial and venous thromboses Developmental disordersvascular system |
| Need for additional follow-up | Pre-operative examination and follow-up after surgical treatment of the heart and vascular structures Suspicion of volumethe first process in the brain or neck organs observation and treatment of cancer that developed in this zone |
These complaints are not unique to vascular pathology brain and neck, but require compulsory doctor's advice.
In the initial treatment of common complaints or before the beginning of treatment, other pathologies always check the vessels outside the skull( neck) and inside( the brain), considering that the clinical manifestations of circulatory disorders of these zones are of a similar nature. Observation of the established disease includes only an assessment of the "zone of interest", there is no need to expand the survey. That is, checking the vascular structures of the head and neck can be done separately.
To investigate the blood flow in the central organ of the nervous system use different methods of diagnosis:
- US;
- rheoencephalography( REG);
- electroencephalography( EEG);
- angiography( X-ray, MR or CT);
- isotope studies( cerebral scintigraphy, OPE CT, PET).
Of these, only the EEG is characterized by "cerebral" specificity( that is, only the brain is being examined), the remaining procedures are the standard for the examination of vessels of any localization.
Most often, one type of examination is sufficient to establish a diagnosis or exclude pathology, but sometimes a combination thereof is necessary.
The research can be recommended by a doctor of any specialty, but mostly it is prescribed by neurologists, cardiologists, angio- and neurosurgeons.
Doctors perform ultrasound and functional diagnostics( ultrasound, REG, EEG), endovascular surgeons( classical angiography) and radiotherapy specialists( MR and CT angiography, isotope studies).
Blood supply to the brain Age features of the research
- Neurosonography( ultrasound through a large fontanel) - used only in children of the first year of life.
- REG is contraindicated before reaching the age of seven.
- MR angiography in early childhood is performed under mild anesthesia, as it requires a period of immobility.
- classical and CT angiography, as well as radioisotope methods of investigation, are conducted in pediatric practice according to strict, more often vital, indications( high radiation dose), and anesthesia is often shown for a complete examination.
Which pathology can be detected on the
| vascular examination? | pathology group Disease or condition |
|---|---|
| Vascular anomalies | Aneurysm( dilated vessel) Malformation( congenital connection of the venous and arterial structure) Fistula( posttraumatic connection between the artery and the vein) Underdevelopment of the Willis circlemain arteries of the brain) |
| Vascular pathology | Vessel stenosis Rupture Thrombosis |
| Bulk processes | Tumors( evil and good Abscess( limited accumulation of pus) Hematoma( blood accumulation) |
Ultrasound, non-invasive( without entering the body tissues) examination method. Several types are used to check the vascular system of the neck and brain.
Neurosonography
Carried only in pediatric practice in children under 1 year( the period before the infection of the fontanelle between the frontal and parietal bones).
Conducting a neurosonic examination Procedure technique: examination through the fontanelle + anterior and lateral surface of the neck.
| Contraindications | Preparation | Time( min) |
|---|---|---|
| No | No | 20-30 |
Color( duplex) scanning and 3D sonography
Duplex examination allows to evaluate both the vascular structures themselves and the nature of the blood flow in them in real time.
Duplex scanning of the vessels of the head and neck The 3D mode allows to obtain a volumetric image of the vascular tree, but does not evaluate the movement of blood along the arteries and veins, which limits the use before the detection of vascular anomalies and before their surgical treatment.
Technique of procedure: examination through the occipital, temporal and orbital areas of the skull + anterior and lateral surface of the neck.
| Contraindications | Preparation | Time( min) |
|---|---|---|
| No | No | 30-40 |
Rheoencephalography
The vascular structures are evaluated based on the measurement of the resistance of their walls when a low-level electrical current is applied.
Currently, the method is used infrequently, due to the development of more accurate methods of diagnosis.
Procedure Technique:
- Electrodes( 2-6) connected to the rheograph are fixed to the skin, the device passes electric discharge on them and fixes changes in vascular structures;
- In the process of research, functional tests( drug, positional) are carried out.
Reoencephalographic examination of | Contraindications | Preparation of | Time( min) |
|---|---|---|
| Early childhood | Do not smoke for 3 hours before procedure | 30 |
Electroencephalography
Record electrical activity of the brain. Indirectly reflects changes in the blood supply of individual structures. In the study of vessels used only as an additional method.
Procedure Technique:
- on the head fix helmet with electro sensors, which remove electropulse activity of the brain;
- during the procedure run a series of tests( light, noise, respiratory)
Electroencephalographic examination and its results | Contraindications | Preparation | Time( min) |
|---|---|---|
| Mental disturbances in acute period Early childhood Psychotrauma during emotional instability | Do not use stimulants in12 hours before the study( nicotine, coffee, energy) Wash your head, do not use styling products Food intake no later than 2 hours before the procedure | 45-120 |
Angiography
Classical or X-ray angiography
Screening of the vascular system with fluoroscopy after insertion of a contrast agent into the blood( visible in X-rays).
Angiography of cerebral vessels. Left - the initial accumulation of contrast in the internal carotid artery, to the right - the distribution of contrast across the rest of its branches. Click on the image to enlarge X-ray angiography is divided into:
- General - the introduction of contrast in the central arteries( aorta and its branches);
- Selective - contrasting begins with large vascular trunks( carotid arteries);
- Super selective - the introduction of contrast in the small arterial branches of the "zone of interest."
The higher the selectivity of contrasting vascular tree, the lower the radiation load in the study.
Peculiarity of the method: requires hospitalization in a hospital.
Procedure procedure:
- femoral artery puncture;
- installation and conduct of a catheter to the study area;
- introduction of a contrast agent and examination of vascular structures.
| Contraindications | Preparation | Time( min) |
|---|---|---|
| Intolerance to iodine-containing drugs Lack of kidney function, liver Pregnancy and lactation | Do not eat or drink for 12 hours before the test | 60-180 |
CT angiography
Obtaining a three-structures due to the combination of multiple images in different projections performed on a computer tomograph. Requires a contrast agent.
Procedure procedure:
- catheter installation in the elbow fold region;
- holding a scan of the zone of interest.
| Contraindications | Preparation | Time( min) |
|---|---|---|
| Same as for X-ray angiography | If diabetes treatment with Metformin is being administered, discontinue use 3 days prior to testing Have a blood test for creatinine within a week before procedure | 20-30 |
MR-angiography
Three-dimensional vascular drawing is obtained by fixing the response of tissue structures to the effect of the electromagnetic field of the tomograph. The main advantage of the method is the absence of irradiation. In controversial cases requires contrast enhancement.
Technique of procedure: after fixing the zone of interest in a special coil, scan is performed, during which it is necessary to lie motionless.
Results of angiography of cerebral vessels | Contraindications | Preparation of | Time( min) |
|---|---|---|
| Early gestation Threat of termination of pregnancy Claustrophobia Presence of metal structures in the body( joint prostheses, fixed fractures) Mental illness during exacerbation | No | 40-60 |
Radionuclide methods
Cerebral scintigraphy
Obtaining a two-dimensional image of the vascular structures of the head and neck by fixing radiation from a radiopharmaceutical injected into the blood( a technologically safe isotope Technetium).
Procedure procedure:
- Intravenous introduction of the isotope.
- Scan the area after 15-45 minutes and 3 hours after the injection.
| Contraindications | Preparation | Time( min) |
|---|---|---|
| Pregnancy and lactation Allergic reaction to the isotope Irradiation( therapeutic or diagnostic) for 3 months before the study | No | 40-60 |
Single-photon emission computed tomography and positron emission tomographyCT, PET)
Obtaining a three-dimensional image of vessels by fixing radiation from the radiopharmaceutical in the blood. The most highly specific methods of examination with high radiation dose.
Procedure Technique:
- catheter placement in the vein;
- carrying out a scan.
| Contraindications | Preparation | Time( min) |
|---|---|---|
| Same as with | Scintigraphy No | 20-30 |
Principle of work of positron emission tomography. Click on the photo to enlarge. Conclusion
To check the vessels of the head and neck from all the listed methods are more often used:
- ultrasound;
- MRI;
- classical angiography.
In 90-95% of cases this is enough to establish a diagnosis or to monitor any pathological process. Advantages of sonography and magnetic tomography:
- Possibility to examine the adult and children's contingent of patients.
- No radiation.
- Non-invasive procedures.
- No need for hospitalization.
- Price of the study.
Radioisotope survey methods allow revealing pathologies that are "not visible" in other studies, but have several drawbacks:
- high radiation dose;
- impossibility of holding outside large cities;
- is a great procedure price.
The decision of a question on necessity of use of any checks of vessels of a head and a neck is accepted by the attending physician individually.