Sunday, September 22, 2013
Diagnosis and Confirmation of a Mild Stroke
Last month our doctor informed us that my wife may have had a mini stroke just recently that we were not aware of. We thought that her symptoms of weakening in her legs and a slight stutter and a slight loss of memory was due to her Parkinson Disease diagnoses about 6 months ago. Our neurologist ordered an ultrasound of her neck first (#1 test). The results showed plaque formation on her right carotid artery. So my wife has indeed carotid artery disease. However, the extent of the blockage is not clearly shown by the ultrasound. So three other instrumental diagnostic tests were ordered besides the first test to confirm and show how extensive is the blockage. The following test were done to my wife during the last four weeks.
1.Medical sonography (ultrasonography) is an ultrasound-based diagnostic medical imaging technique used to visualize muscles, tendons, and many internal organs, to capture their size, structure and any pathological lesions with real time tomographic images. Ultrasound has been used by radiologists and sonographers to image the human body for at least 50 years and has become a widely used diagnostic tool. The technology is relatively inexpensive and portable, especially when compared with other techniques, such as magnetic resonance imaging (MRI) and computed tomography (CT)
2.CT scanning of the head is typically used to detect infarction, tumors, calcifications, haemorrhage and bone trauma. Of the above, hypodense (dark) structures can indicate edema and infarction, hyperdense (bright) structures indicate calcifications and haemorrhage and bone trauma can be seen as disjunction in bone windows. Tumors can be detected by the swelling and anatomical distortion they cause, or by surrounding edema.
3.Magnetic resonance angiography (MRA) generates pictures of the arteries to evaluate them for stenosis (abnormal narrowing) or aneurysms (vessel wall dilatations, at risk of rupture). MRA is often used to evaluate the arteries of the neck and brain, the thoracic and abdominal aorta, the renal arteries, and the legs (called a "run-off").
4.Echocardiogram, often referred to cardiac echo or simply an echo is a sonogram of the heart. (It is not abbreviated as ECG, which in medicine usually refers to an electrocardiogram.) Echocardiography uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart. Echocardiography has become routinely used in the diagnosis, management, and follow-up of patients with any suspected or known heart diseases. It is one of the most widely used diagnostic tests in cardiology. It can provide a wealth of helpful information, including the size and shape of the heart (internal chamber quantification), pumping capacity, and the location and extent of any tissue damage. .
The above four test are all non-invasive tests. There is another test slightly invasive that will confirm the extent of the blockage as follows:
Cerebral angiography (carotid angiogram). This procedure is considered the gold standard for imaging the carotid arteries. It is an invasive procedure that lets a doctor see blood flow through the carotid arteries in real time. Cerebral angiography allows the doctor to see narrowing or blockages on a live X-ray screen as contrast dye is injected in the carotid arteries. This procedure provides the best information. It does carry a small risk of serious complications.
As of this writing date, we have not decided what surgical or medical treatment will be done. We have an appointment to see a vascular surgeon next week. Please pray for my wife's health. The following three web sites are excellent references if you need additional and detailed information on carotid artery disease.