What tests do neurosurgeons do?

The diagnosis of nervous system diseases includes localization diagnosis and qualitative diagnosis, and localization diagnosis is the first step. After comprehensively considering the patient's medical history, symptoms, and signs, clinicians can make preliminary inferences about the lesion location, and then combine with auxiliary examinations to determine the nature of the disease.

Neurology examinations are relatively comprehensive. To understand the required examination items, you must be familiar with the common classifications of neurological diseases, including peripheral neuropathy, central nervous system diseases, movement disorders, and cerebrovascular diseases. In addition to the support of blood biochemical indicators, the following inspections should also provide a reliable basis.

1. Brain imaging examination

(1) Head CT, mainly for the diagnosis of craniocerebral trauma, intracranial hematoma, cerebral hemorrhage, subarachnoid hemorrhage, craniocerebral tumor and other diseases.

(2) Angiography (CTA, DSA) is mainly used for the diagnosis of large artery stenosis, occlusion and cerebral aneurysm. The difference between the two is that DSA requires arterial cannulation to inject contrast agent, which is more expensive; while CTA is administered intravenously, but Lesions with small vessel branches cannot be shown.

(3) Cranial MR, this test uses the resonance signal imaging generated by the movement of H protons in the magnetic field in the human body, and is widely used in the diagnosis of cerebrovascular diseases, central nervous system demyelinating diseases, craniocerebral tumors and other diseases. . Among them, DWI examination has advantages in the identification of acute cerebral infarction, and can be visualized within 2 hours of onset.

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2. Lumbar puncture and cerebrospinal fluid examination

Cerebrospinal fluid exists in the cerebral ventricle and subarachnoid space. Due to the existence of the blood-brain barrier, the chemical components in the blood can only selectively enter the cerebrospinal fluid. Lumbar puncture is suitable for central nervous system infectious diseases, vasculitis, autoimmune encephalopathy, inflammatory demyelinating diseases, malignant tumors involving the meninges, etc.

3. Neurophysiological examination

(1) EEG topography: identification of epilepsy and its classification.

(2) EMG: It mainly provides the basis for the diagnosis of motor neuron disease and muscle atrophy, and differentiates neurogenic and myogenic damage.

4. Ultrasound inspection

(1) Transcranial Doppler: It is of great significance to judge the stenosis, occlusion and arteriovenous malformation of intracranial and extracranial blood vessels.

(2) Color Doppler ultrasound of the carotid artery: observe the wall and diameter of the blood vessels in the neck, and identify the arteriosclerosis, stenosis, aneurysm and arteritis of the neck blood vessels.

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