There are a range of diagnostic tools available to assist in the treatment of hydrocephalus. I will discuss the pro's and con's, from the patient's prospective. Included in the discussion will be 1) X-rays, 2) CT (or CAT) scans, 3) Nuclear Medicine studies, 4) ICP or (Intracranial pressure) studies, 5) MRI's. 6) Eye exams. 7) Ultrasound. 8) Spinal taps
X-rays are used to check the settings of the programmable valve, if one is in place. Sometimes, unknowingly, a person with a programmable valve is subjected to unwanted scans, such as when traveling through an airport. The magnetometer used to check passengers for weapons, is a good example. That can change the settings on a programmable valve. Notice, I said, "can", not "will".
CT's or CAT scan's are used to check the size of the ventricles in the brain. When I had my first CT, it took forever... actually, the scan took around 30 minutes and when you are a kid, 30 minutes is a lifetime! Now, the CT scan can be done in as little as 5 minutes, easy. Yet, there is something that could make the scan take longer. That is the use of radioactive dye. The dye is not harmful and it flushes through the body in no time.
Nuclear Medicine studies are used by some neurosurgeons for a different perspective. Fairly common when I was younger, the CT and MRI are now more often used. Just as the name states, the use of radioactive isotopes are used outline areas of the brain. No long lasting affects have been noted with the use of the radioactive isotopes. As stated above, it flushes through the body in no time.
ICP's or Intracranial Pressure studies are a great tool for the doctor, yet can be the most uncomfortable for the patient, because they have to stay fairly still. There are three types of ICP's in use: 1) Intraventricular catheter, 2) Subdural screw 3) Epidural sensor. Talk things over with your neurosurgeon and find out what they prefer and way. Also, you can do your own research to find out what would be best for your situation.
MRI's offer a different perspective of the brain and in more detail. The downside of the MRI is that it can be quite noisy. The staff offers headsets to drown out the noise and some pipe in music. In my view the MRI can take as long as the old CT (around 30-40 minutes). Yet, the neurosurgeon can get a better idea of the problem. There is one drawback, people with programmable valves really should try and avoid MRI's because the magnet used in the MRI is quite strong and can change the settings on the programmable valve. Not really something you want to have done. Yet, to fix that, you would need to go to your neurosurgeon and have them reset your valve to the setting that works for you.
Eye exams can show if there is pressure on the back of the optic nerve. Ophthalmologists can notify your neurosurgeon if they notice an increase in pressure and refer you back to your neurosurgeon for a follow up. I am not aware if optometrists have the education and training to see that type of change and I do not want to dismiss them out of hand.
Another tool, that I am aware of, is the use of ultrasound. After a programmable valve is implanted, sometimes the location of the valve gets forgotten by the neurosurgeon. There is also interns, residents and fellows that have never seen you and they may use ultrasound to locate the valve. The reason to use an ultrasound is, for example, when a valve may need to be "tapped" to see if it is functioning properly.
Lastly, Spinal taps can show infections in the cerebral spinal fluid. Infections in the CSF can be quite dangerous and need to be treated right away.
No comments:
Post a Comment