Neuro Diagnostic testing

Based on Dr B slides

Computed tomography (CT SCAN)​

• Check allergies to iodine, contrast dyes, shellfish.​

• Assess BUN and creatinine.​

• Encourage fluids post procedure.

Cerebral arteriography

Injection of dye to visualize cerebral arteries. (blood flow)

• Same preparation as CT scan.​

• Keep patient NPO 4-6 hours before procedure.​

• Mark peripheral pulses.​

• Monitor LOC post procedure​

• Check for bleeding or hematoma at insertion site.​

Lumbar puncture

Procedure that inserts a needle into the subarachnoid space of spine.

Nursing Interventions:​

• Verify informed consent has been signed.​

• Have patient empty bladder and bowel.​

• Position patient on side, with knees pulled toward chest and chin tucked down (fetal position).​

• Assess patient and help provider collect fluid.​

• Encourage fluids post procedure.​

• Assess puncture site for redness, swelling, clear drainage.​

• Assess movement of extremities*

Magnetic Resonance Imaging (MRI)

Imaging produced through interaction of magnetic fields, radio waves, and atomic nuclei.​

• Patient must remove all metal objects.​

• Contraindicated for pacemakers, stents, and surgical clips.​

• Titanium joints are ok.​

• Assess for claustrophobia.​

• Assess patient’s ability to lie still in a supine position for 60 min.​

Electroencephalogram (EEG)

Noninvasive assessment of electrical activity of brain.

• Done when there are abnormalities of brain:​

  • Seizure disorders​

  • Head injuries​

  • Tumors​

  • Infections​

  • Degenerative disease​

  • Confirm brain death​

Glasgow Coma Scale (GCS)

Eye Opening, Verbal Response, Motor Response are given a numeric value​

• The total GCS score is the sum of the numeric values.​

• 15 = a fully alert person, and the lowest score is 3.​

• A GCS score of 8 or less indicates a coma.

Ventriculostomy

Catheter placed in lateral ventricle (via burr hole) to measure ICP, drain CSF, and sometimes give intraventricular meds.

• infection can coccur —> s/s of infection

Craniotomy

Opening into skull by removal of bone flap and dura. ​

• Remove lesion/tumor​

• Drain blood​

• Relieve elevated ICP​

Burr Hole

Opening into skull with a drill. ​

• Remove localized fluid and blood beneath top layer dura.

Surgical interventions used to treat hemorrhagic strokes include

based on on the cause of the stroke.

• Resection or Clipping of an aneurysm​

• Evacuation of hematomas​

Carotid artery angioplasty with stenting (CAS)

Inserting a catheter in the femoral artery and placing a protection device to catch clot debris ​

Carotid endarterectomy

removes atherosclerotic plaque. ​

• performed when the carotid artery is blocked or when the client is experiencing TIAs.​