|
Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Brain Angiogram? Possible CNS VasculitisForum: Neurology Forum
| ||||
Re: Brain Angiogram? Possible CNS VasculitisPosted by CCF Neuro MD *!* on November 24, 1997 at 21:24:31: In Reply to: Brain Angiogram? Possible CNS Vasculitis posted by Pamela on November 14, 1997 at 15:51:08:
: I will be having a brain angiogram very soon to look for possible CNS Vasculitis. But it is more likely that I have something else, none of the many doctors (including neurologists at Georgetown, Mayo, and Hopkins) I have seen have been able to figure it out. A brain biopsy was considered but ruled out as too dangerous by the Neurosurgeon. I have various lesions in my brain most are in the white matter, these are on the brainstem and near the ventricles. But I also have a GREY MATTER lesion in my right occipedal (sp?) lobe, this is the one causing the vasculitis concern. I also have Lymphocytes in my CSF. There are no other indications of vasculitis. My doctor is really concerned about finding the cause of my lesions because I had a very bad time this summer from the brainstem lesion and he says I can't afford another one. (My heart rate hovered around 30 for several days and the vertigo was so severe that I could not move my head for nearly a month.) Other diagnosies that have been considered are Atypical MS, Chronic meningitis, and some sort of unidentified virus. = Dear Pamela, It certainly seems that you a very complex disorder which has baffled many doctors so far . I would not attempt to suggest a diagnosis based on the limited information in your message but I can definitely give you some data on the angiogram. The angiogram procedure basically involves inserting a very fine tube thorough a needle placed in the femoral artery in the groin and threading it up through the aorta to the blood vessels which supply your brain, at this point a dye is injected and X-rays are taken, the dye fills the vessel and the outline of individual vessels is seen on the x ray film. In vasculitis the blood vessels are inflamed and distorted and the variation in shape and calibre is seen on the X ray film. The test would also identify anatomical abnormalities like aneurysms (swelling of a vessel at a weak point), vessels which are occluded by a clot , as in strokes , AVM’s’ which are tangled masses of overgrown vessels or the distinctive pattern of vessel growth found around a tumor. A SPECT scan measures blood flow in a different way, it shows the overall amount of blood flow in a given area, but does not identify individual vessels, for this reason an angiogram would be the obvious test for vasculitis, but this does not preclude SPECT being suggested at a later date. As regards special preparations , I would not think anything is needed apart from any instructions you may be given with regard to fasting , the risks are those of any invasive procedure i.e. infection , bleeding at the site of puncture in the groin and in the case of brain angio a very small risk of stroke If you need a SPECT scan I am sure the scan is available in Johns Hopkins You might ask your neurologists if they have considered Behcets disease although I suspect this has been considered a long time ago. I wish you luck with your ongoing evaluation. This information is provided for general medical education purposes only.
|
| |||