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Wednesday, 27 November 2013

Reversible cerebral vasoconstriction syndrome - The Diagnosis

Reversible cerebral vasoconstriction syndrome (RCVS)
Reversible cerebral vasoconstriction syndrome, sometimes called Call-Fleming syndrome is defined as a condition of disease of the arteries of which the brain develops a blood vessels spasm that leads to multifocal arterial constriction and dilation, causing the sudden onset of a severe headache (2)
Diagnosis
1. Catheter angiogram 
Catheter angiogram, is the use of a thin plastic tube, called a catheter, is inserted into a large artery and threaded through the circulatory system to the carotid artery, through a small incision in the skin, together with X-rays and a contrast dye in visualizing the blood vessels of the brain. Then a series of radiographs is taken as the contrast agent spreads through the brain's arterial system, then a second series as it reaches the venous system.

2. CT scan
CT scan can dive your doctor a three-dimensional view of your blood vessels of the brain to look for masses and other abnormalities that cause Reversible cerebral vasoconstriction syndrome

3.  Magnetic resonance imaging (MRI)
By using radio waves and magnetic fields to take pictures, MRI scan provides very high quality of a cross-sectional slice and lengthwise slices of the brain and thus providing the better and detail image of location of tumor and the surrounding structures. It is one of most likely early test ordered by a doctor to diagnose tumors, strokes, aneurysms, neurological diseases and other brain abnormalities and the blood vessels around the brain.

4. Computed tomography angiography (CTA)
CTA is a test to create detailed images of the blood vessels of the brain to look for neurological diseases and any abnormality with the use of the combination of the technology of a conventional CT scan with that of traditional angiography.

5. Cerebral magnetic resonance angiography (MRA)
Magnetic resonance angiography (MRA) is an accurate non-invasive tool for imaging the cerebral vessels. It provides morphologic information about the cerebral vessels relying on blood flow as the physical basis for generating contrast between stationary tissues and moving spins. 'Selective' MRA gives functional information about the cerebrovascular system such as flow direction, origin of flow, and presence or absence of collaterals. Arteries and veins can be imaged selectively due to their usually opposite flow directions. Although at a relatively early stage of development, MRA has already become a widely used tool for the study of the cerebrovascular system(12)
In the study of One hundred five (79%) of all 133 aneurysms detected with MRA by a neuroradiologist, 100 (75%) detected by an experienced neurosurgeon, 84 (63%) detected by a general radiologist, and 80 (60%) detected by a resident neuroradiologist, conducted by Nagatomi Neurosurgical Hospital, found that although MRA is useful in the diagnosis of cerebral aneurysms, sufficient experience and careful attention are necessary for accurate diagnosis of aneurysms located at the internal carotid and anterior cerebral arteries(13)

6. Etc
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Sources
(2) http://www.ncbi.nlm.nih.gov/pubmed/19220301 
(12) http://www.biomedsearch.com/nih/Cerebral-magnetic-resonance-angiography/1355864.html 
(13) http://www.ncbi.nlm.nih.gov/pubmed/12105357