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Neurology (Expert Forum)
CTA vs MRA help please
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CTA vs MRA help please
by vin401, Dec 11, 2005 12:00AM
MRA vs CTA
My doct has ordered a repeat of the MRA of the brain and neck that I had 6 months ago, but this time with contrast (as opposed to non-contrast before).
My exam is for: continued features of intense, randomly eposodic positional CNS vertigo (per an oto-neurologist), chronic dull headache which is better in the morning, CONFUSION (moving objects become a mental blur and hurt my eyes and head till I just have to put my head in my heads and cut off my senses till I regain my composure).
My doc told me there was a new standard, the CT angiogram, but grumbled about radiation exposure, and he simply ordered the MRA with no further discussion. Perhaps I should call and ask him to change his mind if it would be better for detection of abnormalities?
1) Might the CTA may show better details in the smaller blood vessels than the MRA. Plus, the MRA before was negative (again, without contrast), so would CTA be better as a "different view" than that MRA. Also, I hear there is an MR study designed for the smaller blood vessels, is this true?
2) Are there any other tests that might be done to find out the cause for severe nausea, attacks of positional CNS type vertigo, constant headache as described above, borderline delirium/attacks of fear and anxiety?
BILI TOTAL, BILI INDIRECT, AND PROTEIN C, very slightly above the normal range, but doctor didn't show concern). ENG negative
Topomax, Inderal LA, Lexapro, and Verapamil have failed to help.
36 yr male Thanks doctor!
My doct has ordered a repeat of the MRA of the brain and neck that I had 6 months ago, but this time with contrast (as opposed to non-contrast before).
My exam is for: continued features of intense, randomly eposodic positional CNS vertigo (per an oto-neurologist), chronic dull headache which is better in the morning, CONFUSION (moving objects become a mental blur and hurt my eyes and head till I just have to put my head in my heads and cut off my senses till I regain my composure).
My doc told me there was a new standard, the CT angiogram, but grumbled about radiation exposure, and he simply ordered the MRA with no further discussion. Perhaps I should call and ask him to change his mind if it would be better for detection of abnormalities?
1) Might the CTA may show better details in the smaller blood vessels than the MRA. Plus, the MRA before was negative (again, without contrast), so would CTA be better as a "different view" than that MRA. Also, I hear there is an MR study designed for the smaller blood vessels, is this true?
2) Are there any other tests that might be done to find out the cause for severe nausea, attacks of positional CNS type vertigo, constant headache as described above, borderline delirium/attacks of fear and anxiety?
BILI TOTAL, BILI INDIRECT, AND PROTEIN C, very slightly above the normal range, but doctor didn't show concern). ENG negative
Topomax, Inderal LA, Lexapro, and Verapamil have failed to help.
36 yr male Thanks doctor!
Doctor's Answer
by CCF-Neuro-M.D.-PW, Dec 14, 2005 12:00AM
1) MR contrast enhanced angiography and CT angiography are newer tests that we are learning more about every day. They are both sufficient tests to evaluate and screeen the cerebral blood vessels. For some specific purposes, a CTA may be used over an MRA or vice versa such as using CTA to define known cerebral aneuryms prior to intervention. THe radiation dose for CTA is small with the newer generation scanners, while MRI involves no dangerous radiation at all. MRA is probably not quite as good for smaller blood vessels compared to CTA. There is no specific MRI study available for smaller studies. CTA does not give a 'different view' to MRA - your blood vessels remain the same.
2) I cannot give you a clinical diagnosis over the internet, but severe nausea with vertigo is more suggestive of a middle or inner ear disorder - are you sure this has been excluded? Migraine is also another common cause of headache, nausea, and vetigo.
Good luck
2) I cannot give you a clinical diagnosis over the internet, but severe nausea with vertigo is more suggestive of a middle or inner ear disorder - are you sure this has been excluded? Migraine is also another common cause of headache, nausea, and vetigo.
Good luck
MRA is a good initial screen, and you may find what you're looking for on the MRA.