The brain is the most complex organ in the human body, as it connects all body systems. This is why brain imaging is performed using the most advanced diagnostic equipment.
When is it necessary to examine the brain?
Using high-precision brain diagnostics, a doctor can make a diagnosis or monitor the progression of a disease. A neurologist, phlebologist, or traumatologist may prescribe brain or vascular examinations for the following complaints:
- headaches of unclear origin;
- head injuries;
- loss of sensation in the limbs, decreased vision, hearing and smell;
- loss of coordination, constant general weakness;
When a stroke is suspected and tumors and epilepsy are diagnosed, examinations are essential—they can detect tumors, vascular blockages and ruptures, hematomas, foreign bodies, and dysfunctional areas of the brain. Since pathologies in different parts of the head can cause completely different symptoms, doctors often order brain imaging.
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Types of brain research
The most common and informative types of brain imaging are computed tomography (CT) and magnetic resonance imaging (MRI). These scans provide high-quality images of the brain in multiple projections, aiding in the diagnosis of any condition.
Magnetic resonance imaging of the brain
An absolutely safe examination method with virtually no contraindications. It is only dangerous for patients with pacemakers or metal implants, as the CT scanner’s magnetic field can displace or heat metal objects and disrupt their operation.
The resulting image allows one to visualize dense and soft tissues, blood vessels, and tumors. An MRI scan is performed in multiple projections at the required depth, allowing the doctor to assess the condition of any area of the brain.
Before the procedure, you must remove all metal objects and accessories. To avoid undressing before the examination, you can simply wear clothing without zippers or metal buttons.
For an MRI, the patient lies down on a couch. The technician may provide headphones to protect against very loud sounds during the procedure. The patient is then placed inside the scanner. It is important to remain still, as changing position will distort the image. The brain scan typically lasts no more than half an hour. If the patient feels uncomfortable, the procedure can be stopped or paused without affecting the imaging results.
Computed tomography of the brain
It uses X-rays, so it’s not recommended for children, pregnant women, or breastfeeding women. However, it’s completely safe for all other patients.
A CT scan can produce a 3D image of the brain . It’s as high-quality as an MRI, showing all brain structures and blood vessels. Therefore, the choice between the two types of tomography is based solely on the existing contraindications.
Metal objects will also need to be removed: they aren’t as dangerous as with an MRI, but they do interfere with the radiation. Failure to do so will result in loss of some of the image.
A significant advantage of CT scanning is that minor changes in body position won’t affect the results. Otherwise, the procedure is little different from an MRI. The patient is placed in the scanner on a couch and monitored throughout the procedure. The scan lasts no more than 15–20 minutes and can be stopped at any time at the patient’s request.
A CT scan can be performed using a contrast agent to obtain more detailed and clear images. This involves first performing a standard scan, then injecting the patient with a dye intravenously. The procedure then continues for several minutes.
Other types of research
In addition to tomography, several other types of diagnostics are used to examine the brain:
- Electroencephalography (EEG) records fluctuations in the brain’s electrical impulses. Electrodes are attached to the patient’s scalp, through which the brain’s bioelectric currents are recorded and displayed on paper or a screen. This test can be helpful in cases of mental and speech delays, epilepsy, and trauma, as it can identify inactive areas of the brain.
- Craniography is an X-ray of the skull in two projections. It uses very low-level radiation to avoid harming the patient. These images can help identify congenital defects and injuries to the skull bones.
- Neurosonography is an ultrasound examination of the brain in children from birth until the fontanelle closes. It is not as informative as tomography and X-rays, but it is one of the few safe methods for examining newborns.
- Electroneuromyography (EMG) tests the conduction of nerve impulses. Electrodes are placed on the skin over the nerves, and an electrical impulse is sent through them. Based on the intensity of muscle contractions, the doctor can determine the nerve’s function.
How is a vascular examination performed?
Angiography and ultrasound are used to examine the veins and arteries of the brain. Both are safe, informative, and have minimal contraindications.
Magnetic resonance angiography
It provides the best results for examining small vessels and nerve trunks. During the examination, the doctor will obtain an image of all the vessels in your brain. This will help diagnose mini-strokes and thromboses that are not visible on a standard MRI of the head. It is often prescribed by surgeons after operations to monitor the condition.
MRA is performed in the same way as conventional magnetic resonance imaging (MRI) and has the same features and contraindications. All metal objects must be removed before the procedure, and head movement must be avoided while the scanner is in use. Often, for a proper diagnosis, angiography should be combined with a brain MRI—this allows for a more detailed examination of the affected area.
Computer angiography
A cerebral vascular angiography (CVA) is similar in procedure to a computed tomography (CT) scan. The procedure provides the physician with a 3D model of the brain’s blood vessels. The resulting image can be used to visualize venous and arterial anomalies, atherosclerosis, vascular stenosis, and tumors.
A doctor may prescribe this examination both to prepare for surgery and for post-treatment monitoring. Furthermore, this type of examination is an option for patients who cannot undergo MRA due to contraindications.
Computed tomography angiography can use a contrast agent to better visualize damaged areas. Contraindications for the procedure are the same as for CT: pregnancy and childhood.
Doppler ultrasound
The ultrasound transducer is placed on the thinnest bones of the skull. Ultrasound can detect narrowing or thrombosis in the brain vessels, measure blood flow velocity, and detect aneurysms and areas with altered blood flow. The image is displayed on a monitor screen, and, if necessary, the desired frame can be printed.
Ultrasound can be used to examine both intracranial and cervical vessels if they are causing cerebral blood flow obstruction. The method has no contraindications and is completely safe for patients of any age. Ultrasound requires no additional preparation or examinations; however, it is best to avoid foods and medications that affect vascular tone before the procedure.
What determines the choice of research?
The most common methods for examining the brain are MRI, CT, and ultrasound. They are quite informative for the vast majority of possible diseases. If you don’t know your diagnosis and want to bring your test results to the doctor, an MRI or CT scan is the best option. They provide sufficient information on the condition of both the brain and bone tissue, and they can also identify major vessels.
In cases of head injuries, a craniogram should be performed first. It will provide sufficient information about the integrity of the skull, and if no foreign bodies have entered the brain, other diagnostic tests will be unnecessary. If the injury is more serious, with internal bleeding and brain damage, a CT scan will definitely be performed.
If your doctor has prescribed a cerebral vascular examination, you should consider your own contraindications and the availability of these tests. Both CT and ultrasound provide equally good results.
The doctor’s decision remains the deciding factor in choosing tests. Serious diagnostics are only performed with a doctor’s referral. It’s quite possible that your doctor will prescribe several procedures for a more comprehensive examination and an accurate diagnosis.
You might also be interested in:
- What to do if you have a constant headache
- Why does the back of my head hurt?
- Signs of a brain tumor
Bibliography
- Zenkov L.R. Clinical electroencephalography (with elements of epileptology). Manual for physicians / L.R. Zenkov. – 5th ed. – Moscow: MEDpressinform, 2012. – 356 p.
- Kulaichev A.P. Computer Electrophysiology. 3rd ed., revised and enlarged. Moscow: Moscow State University Press, 2002. –380 p.
- Sheftell, FD Post-traumatic headache: Emphasis on chronic types following mild closed head injury / FD Sheftell, SJ Tepper, CL Lay [et al.] // Neurol. Sci. – 2007. Vol. 28. – P. S203-S207
- Obermann, M. Post-traumatic headache // M. Obermann, D. Holle, Z. Katsarava // Expert Rev. Neurother. – 2009. – Vol. 9. – P. 1361–1370.
- Korzhevsky D. et al. (eds.). Immunohistochemical study of the brain. – Litres, 2022. link
- Polskoy V. S., Varavina E. V. Modern methods of studying the human brain // Integrative trends in medicine and education. – 2020. – Vol. 3. – P. 87-90. link
