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How accurate is Myelography | Neurology

What is myelography?

Myelography is an imaging test that involves inserting a spinal needle into the spinal canal and injecting contrast material into the area around the spinal cord and nerve roots (subarachnoid space) under real-time fluoroscopy.

Radiography (radiography) is an unplanned medical test that helps doctors diagnose and treat medical conditions. X-ray images produce images of the inside of the body by exposing a part of the body to a small dose of ionizing radiation. X-rays are the oldest and most widely used form of medical imaging.

Preparation for myelography

Always follow the instructions provided by your doctor and/or neurobiologist. In general, most references may include the following:

  • Arrange for someone to drive you to the hospital/radiology center and home after the test.
  • The neuroradiologist may ask you to bring previous and related X-rays, CT scans, or copies of MRI scans (eg, CDs) for review. Previous radiological studies can be compared with myelography images.
  • Do not eat anything after midnight before your myelogram appointment. Clear liquids are generally acceptable.
  • If you need to take any medicine on the day of your appointment, take it with a clear liquid (for example, water) unless your doctor gives you other instructions.
  • You may be instructed to keep jewelry and valuables at home.

Purpose of myelography

A myelogram is done to examine the spinal cord, subarachnoid space, or other structures for defects or changes. When standard X-ray, does not give clear answers about the cause of back or spine problems, the test is suggested. Myelograms can be used to evaluate many diseases, including:

  • Herniated discs (discs that bulge and press on nerves and/or the spinal cord)
  • Spinal cord
  • Brain tumors
  • Infection and/or inflammation of tissues around the spinal cord and brain
  • Spinal stenosis is the degeneration and swelling of the bones and tissues around the spinal cord that make the canal narrow
  • Ankylosing spondylitis is a disease that affects the spine, causing the bones to grow together
  • Bone spurs
  • Arthritic discs
  • Cysts are benign capsules that are filled with fluid or solid matter.
  • Tearing away or injury of spinal nerve roots
  • Arachnoiditis (inflammation of a delicate membrane that covers the brain.)

There may be other reasons for suggesting the myelogram test.

Before the myelography

Always follow the instructions provided by your doctor and/or neurobiologist. In general, most references may include the following:

  • Arrange for someone to drive you to the hospital/radiology center and home after the test.
  • You may be asked to bring previous and related X-rays, CT scans, or copies of MRIs (eg, CDs) for a neurobiologist to review. Previous radiological studies can be compared with myelographic images.
  • Do not eat anything after midnight before your myelogram appointment. Clear liquids are generally acceptable.
  • If you need to take any medicine on the day of your appointment, take it with a clear liquid (for example, water) unless your doctor gives you other instructions.
  • You may be instructed to keep jewelry and valuables at home.

During the myelography

  • The duration of the procedure varies, but on average it is 1 hour.
  • The technician will place you on the testing table, usually face down.
  • Computed tomography is performed following this procedure.
  • A technician and a radiologist will be available to answer any questions.

After the myelography

After the procedure, you will be taken to the radiology waiting area for your exam. It is important to keep the head slightly elevated for 24 hours after the myelogram. Use 1-2 pillows on the bed. Do not go to bed until the next morning or allow your head to be lower than the rest of your body.

Drink more fluids throughout the day. Drinks with alcohol and caffeine are restricted prior to the test. If you go home, you will be given discharge instructions.

What to expect from the procedure?

A myelogram will help to examine your spinal cord, spinal nerves, nerve roots, and bones in the spine by injecting contrast into your spinal fluid. As a result, it will also help to find whether anything is pressing against your spinal cord or nerves. There are a few different things that could be responsible for causing this pain and unwanted pressure in the spinal cord, including:

  • Herniated or bulging discs.
  • Arthritis in your spinal joints.
  • Tumors within, or adjacent to, your spine.
  • An infection, or other inflammatory processes.
  • Compared to an MRI, a myelogram, and the post myelogram CT scan, is able to show the bony details in a better way but is less capable of showing the soft tissue details in your spine.

How long should you rest after a myelogram?

  • After the test, it is usually not necessary to remove the contrast material from the spinal canal. Myographic contrast material is absorbed by your body and naturally eliminated by your kidneys through urination within 1-2 days.
  • Drink more fluids, 1 cup every hour until bedtime, unless your doctor prescribes it
  • Liquids help remove the contrast medium from your body and prevent headaches.
  • Avoid physical activity that leans down.
  • If possible, avoid coughing, sneezing, sneezing, and rapid movements for 24 to 48 hours.
  • You can immediately resume medication and diet before the test.
  • You will be in the radiology recovery room for about 2 hours.
  • Before you are discharged, the nurse will instruct you to take it home.
  • Have someone with you who can drive you home. You cannot drive home alone.

Side effects of myelography

Most patients do not experience side effects after myelography. The most common side effect is a headache, which usually goes away with rest and fluids within a day or two. Other side effects include nausea, dizziness, widespread pain, nausea, and/or vomiting.

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Tests

Overview of Electroencephalogram (EEG) | Neurology

What is an electroencephalogram (EEG)?

An electroencephalogram (EEG), is a test that estimates the electrical activity of the brain. It can be done to diagnose or observe diseases that affect the brain, such as epilepsy and sleep disorders. Your doctor will inform you if you need an EEG. The loads are stretched and appear on the computer screen as a graph or a recording on paper. Then your healthcare provider will explain the reading to you.

During an electroencephalogram (EEG), your healthcare provider will usually estimate the activity of 100 pages or computer screens. He or she pays special attention to the primary waveform but also examines responses to stimuli such as brief bursts of energy and flashing lights.

Purpose of electroencephalogram

The electroencephalogram (EEG) is used to identify problems associated with certain brain disorders in the electrical activity of the brain. Measurements given by EEG are used to confirm or rule out various conditions:

  • Seizure disorders (such as epilepsy)
  • Head injury
  • Encephalitis (inflammation of the brain)
  • Brain tumor
  • Encephalopathy (a disease that causes brain dysfunction)
  • Memory problems
  • Sleep disorders
  • Stroke
  • Dementia

When someone is in a coma, an EEG can be done to determine the level of brain activity. This test can also be used to monitor activity during brain surgery.

Where is electroencephalogram (EEG) tests done?

The EEG is usually performed in the hospital at the outpatient clinic. People with epilepsy have told us that it would be helpful for them to go on a date with someone. Some people are very tired of this process and are less likely to have seizures during the test. It may help to plan how you will get home after your appointment.

You may be asked to bring some simple portable recording equipment with you. You will be shown how to operate it.

Risk factors

An electroencephalogram has been done for many years and is considered a safe procedure. The test does not cause any discomfort. Electrodes record activity. They do not produce any sensation. Also, there is no risk of electric shock.

Certain factors or conditions can interfere with the reading of the EEG test. Besides these:

  • Low blood sugar (hypoglycemia) created by fasting
  • Body or eye movement through the tests (but this will rarely, if ever, significantly prevent the interpretation of the test)
  • Lights, especially bright or flashing ones
  • Certain drugs, such as sedatives
  • Drinks such as coffee, cola, and tea (these beverages may occasionally alter EEG results, which does not significantly interfere with test interpretation)
  • Oily hair or the behavior of hair spray

Procedure

Preparing for electroencephalogram

The patient is told when the electroencephalogram is scheduled.

  • If the patient is taking restrictive medications routinely to prevent seizures, antidepressants, or stimulants, they may be asked to stop taking these medications 1 to 2 days before the test.
  • The patient is told not to ingest caffeine before the test.
  • The patient should not use hair products (hairspray or gel) on the day of the test.
  • It is prudent to take the patient to the EEG site, especially if he or she wants to refrain from taking overdose medications.
  • If the patient has a sleep EEG, they may be asked to stay awake the night before the test.

During electroencephalogram

During an electroencephalogram, 20 electrodes are placed on your scalp while you lie on the exam table or in bed. Open your eyes first, then close them and relax. You may be asked to inhale deeply and quickly or to stare at a flashing light; both activities cause changes in brain wave patterns. If you are prone to epilepsy, you will rarely experience one during the test. If you are being evaluated for a sleep disorder, you may have a continuous EEG done at night while you sleep. This recording, which assesses other bodily functions such as breathing and pulse during sleep, is called polysomnography.

After electroencephalogram

Once the test is complete, the electrodes are removed and you are allowed to stand up. The results must be analyzed at a later stage by a neurologist (a doctor who specializes in brain disorders).

Generally, if there are no abnormalities in the electrical activity of the brain, the pattern of “peaks and valleys” traced by the electroencephalogram should be fairly regular. If excited, the pattern will show considerable variation and any deviation from the regular pattern may indicate abnormalities.

Results

Once the electroencephalogram results have been analyzed, they are sent to your doctor, who will accompany you. The EEG looks like a series of wavy lines. The lines will look different depending on whether you are awake or asleep during the test, but each state will have a general pattern of brain activity. If the regular brain wave pattern is disturbed, it could be a type of epilepsy or another brain disorder.

Having an abnormal EEG does not mean you have epilepsy. The test records what is happening in your brain at that moment. Your doctor will do other tests to confirm the diagnosis.

Complications

Complications of electroencephalogram (EEG) include:

  • You move too much.
  • You take certain medicines. This involves medicines used to treat seizures (antiepileptic medicines), sedatives, tranquilizers, and barbiturates.
  • You took coffee, soda, or tea, or you ate extra foods that have caffeine before the test.
  • You are careless from severe drug poisoning or very low body temperature (hypothermia).
  • Your hair is dirty, oily, or treated with hair spray or other hair products. This can create a problem with how the electrodes are placed.
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Know the Procedure of Angiography | Neurology

What is angiography?

Angiography is an X-ray procedure in which dye is added into the chambers of your heart or into the arteries that lead to your heart (coronary arteries). Then, doctors can measure blood flow and blood pressure in the chambers of the heart and see if the coronary arteries are blocked.

When imaging is taken, an iodine-based contrast medium usually enters the system. The medium highlights the movement of blood through the vessels.

Purpose of angiography

X-ray angiography is performed to specifically diagnose and diagnose vascular diseases of the body, including the brain and heart. Traditionally, angiography has been used to diagnose pathology in these vessels, such as blockage caused by plaque buildup.

However, in current decades, radiologists, cardiologists, and vascular surgeons have practiced X-ray angiography to guide minimally invasive surgery of the blood vessels and arteries of the heart. In recent years, diagnostic vascular imaging has often been performed using MRI, CT, and/or ultrasound and has become specialized for the treatment of X-ray angiography.

Types of angiography

There are several types of angiography used to diagnose a variety of problems:

  • Computed tomography angiography (CTA) uses X-rays, software, and hardware to produce horizontal or axial images or fragments of blood vessels for diagnosis.
  • Coronary angiography is a diagnostic image that uses color and special X-rays to show the inside of the coronary (heart) arteries. These images are used to identify chest pain and arterial narrowing that can lead to future heart attacks.
  • Digital subtraction angiography (DSA): Presents a picture of the blood vessels in the brain to know a problem with blood flow. In this procedure, a catheter (small, thin tube) is injected into an artery in the leg and sent to the blood vessels in the brain. Contrast dye is injected through the catheter, and X-ray images are obtained from the blood vessels.
  • Magnetic resonance angiography (MRA) uses magnetic resonance imaging (MRI) and contrast dye to reflect blood vessels. Doctors often use MRA to examine the heart and other soft tissues and assess blood flow.
  • Pulmonary angiography: An X-ray image of blood vessels used to diagnose various conditions, such as aneurysm, stenosis (narrowing of the blood vessels), or obstruction. The dye (contrast) is injected through a thin, flexible tube that is placed into the artery. This dye makes the blood vessels visible on X-rays.
  • Renal angiography: It is an X-ray image of the renal artery, which is generally used to evaluate the occlusion of the renal artery in patients with drug-resistant hypertension.
  • Radionuclide angiography (RNA) is a type of nuclear medicine procedure. A small amount of a radioactive substance called a radionuclide (radiopharmaceutical or radioactive tracer) is used to help in the examination of the studied tissue. Specifically, relaxation assesses the chambers of the heart on the movement of RNA.

Risk factors

Risk factors for angiography include:

All medical procedures have certain risks. The risks of angiograms are minimal. Accidents include injury to the catheter insertion site, internal bleeding, hematoma or arterial damage, and a small risk of stroke. An allergic reaction to the contrast dye can cause a rash, swelling, trouble breathing, or heart problems. This test should not be given to pregnant or bleeding women.

Every effort is made to ensure that these losses are minimal. Our nurse practitioners and interventional neuroradiologists will discuss your specific risks with you before angiography.

Procedure of angiography

Preparation for angiography

  • You are usually hospitalized as a day patient for this procedure
  • Bring your referral letter or application form and all X-rays taken during the last 2 years
  • Leave the X-rays with the radiology staff because the doctor will need to see them. The radiology staff will inform you when they are ready to be picked up.
  • Wear comfortable, loose clothing
  • Leave all jewelry and valuables at home
  • You may be requested not to eat for 4 hours before the angiogram
  • You will be allowed to drink clear liquids such as black tea, coffee, clear soup, or water for four hours before your angiogram. Having fluids is very important for the kidneys.

Once the person checks in, a nurse takes them to a private room where they can put on a hospital gown.

The nurse then inserts an intravenous line into a small vein in the person’s hand or wrist. They also monitor a person’s vitals, including their weight, body temperature, heart rate, and blood pressure.

During angiography

Before the angiography, a doctor will prescribe a mild sedative to help the person relax. It does not induce unconsciousness.

Then the doctor will disinfect and numb the area of the body where the catheter will be inserted. They made small incisions in the skin and inserted a catheter into the artery.

Once the catheter is inside the artery, the doctor will correctly guide them to the blood vessel they want to measure. They inject a contrast medium through a catheter and take X-ray images of the blood vessels. The person may feel a slight burning sensation when the doctor injects the contrast medium.

After angiography

You will be observed for 4 to 6 hours. During that time, the radiology nurse will discuss the instructions with you at home. A written form of these instructions will be provided to you. Follow these at home.

The radiologist will evaluate you before you are discharged. Then your doctor will discuss the test results with you.

If you have diabetes, do not take Glucophage (metformin hydrochloride) for 48 hours after the test to reduce the risk of kidney problems.

Side effects

After angiography, many people have:

  • Bruising
  • Soreness
  • A very small bump or group of blood near wherever the cut was made

These problems should get better in a few days or weeks, and you generally don’t need to worry.

You can take pain relievers like paracetamol for any discomfort if you need it.

Complications

Minor problems with the angiography procedure:

  • Excessive bleeding at the incision site
  • Infection at the incision site, which may need treatment with antibiotics
  • Mild to a moderate allergic reaction to contrast medium; This can usually be controlled through the use of allergy medications.

More serious complications can include:

  • Blood clots 
  • Kidney damage
  • Stroke
  • Blood vessel damage
  • A serious, life-threatening allergic effect (anaphylaxis) to the contrast dye

9 signs you should go see the doctor

  • Signs of infection such as fever or chills
  • Redness, swelling, growing pain, unnecessary bleeding, or any discharge from the site
  • Extreme sweating, nausea, or vomiting
  • Extreme pain
  • Extreme chest pain
  • Leg or arm feels cold, turns white or blue, or grows numb or tingly
  • Trouble breathing
  • Problems speaking or seeing
  • Weakness in the face