cvd diagnostic exams

8/3/2019 Cvd Diagnostic Exams

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CVD DIAGNOSTIC

EVALUATION



Cerebral Angiography , digital

subtraction angiography, CT

angiography, MRA, Doppler u/s all provide information about carotid and

intracranial circulation

P artial P rothrombin time ( P TT) or

International Normalized Ratio (INR) if

anticoagulation is considered. Blood

levels are monitored to document

therapuetic ranges and determinedosing. PTT is utilized for heparin

therapy and INR is utilized for oral

warf arin (Coumadin) therapy.



Diffusion-weighted MRI may be done

to rule out stroke.

Transesophageal echocardiography torule out emboli from heart.



CVA DIAGNOSTIC EVALUATION



Carotid u/s to detect carotid

stenosis

CT Scan to determine the causeand location of stroke

MRA or CT Angiogram noninvasive

evaluation of cerebrovascularstructures

Cerebral angiography to

determine extent of cerebrovascular

insufficiency & to evaluate forstructural lab abormalities



PE T, MRI with diffusion-weighted images to locate ischemic damage

TCD noninvasive method used to

evaluate cerebral perfusion. Useful

in the bedside evaluation and to

provide a means for ongoing

monitoring of cerebral blood f low to

document changes and trends.



PET

TCP



Rupture of Intracranial Aneurysm

DIAGNOSTIC EVALUATION



History and P hysical Ex am

CT Scan to determine presence of

blood in subarachnoid space, rule

out other lesions, and to evaluate

mass effect. Lumbar P uncture (if no mass effect

on CT): grossly bloody CSF w/ more

than 25,000 RBCs, CSF will not clear

w/ subsequent taps as a traumatictap would.



MRI and MRA or CT Angiogram

noninvasive evaluation of cerebral

vascular structures. Can be useful inthe workup of suspected aneurysms

(individuals w/ persistent headaches

or unexplained neurologic deficits

such as cranial nerve palsies).

Cerebral angiogram gold standard

test; provides definitive evaluation of

aneurysm etiology, presence, location

& configuration; will also reveal

presence of vasospasm, extent of

vasospasm & collateral circulation.



TCD noninvasive method used to

evaluate cerebral perfusion. Useful

in the bedside evaluation and toprovide a means for ongoing

monitoring of cerebral blood f low to

document changes and trends.



Rupture of Intracranial

Arteriovenous Malformation

DIAGNOSTIC EVALUATION



History and P hysical Ex amination

CT Scan to determine presence of

blood, rule out other lesions;

increased density if blood is present,

may also show increased ICP or

mass effect MRI and MRA or CT Angiogram

noninvasive evaluation of cerebral

vascular structures. Useful in the

diagnosis of AVM, but does not define vascular changes and f low

patterns.



Cerebral angiogram gold standardtest; provides definitive evaluation of

AVM presence, location, & vascular

structure. Will also evaluate f low

patterns, pressure gradients,collateral circulation, identify

intranidal aneurysms, & feeding

vessels.

cvd diagnostic exams

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