Brain examination items are:
1. Cerebrospinal fluid examination: The pressure of lumbar puncture is mostly increased. Some tumors, such as those located on the surface of the brain or in the ventricle, can increase the amount of protein in cerebrospinal fluid and the number of white blood cells, and some tumor cells can be found. However, if the intracranial pressure is significantly increased, lumbar puncture may promote cerebral hernia. Therefore, it is generally only done when necessary, such as when it needs to be differentiated from inflammation or bleeding. If the pressure rises obviously, be careful and don't put too much cerebrospinal fluid. Mannitol drip was given after operation and observed.
2, ultrasound examination: can help determine the lateral position and observe whether there is hydrocephalus. The baby can be scanned by B-ultrasound through the front fontanel, and tumor images and other lesions can be displayed.
3. EEG examination: On the one hand, the EEG changes of glioma are limited to the brain wave changes at the tumor site. On the other hand, the frequency and amplitude of the general distribution change. These are influenced by tumor size, invasion, degree of brain edema and increased intracranial pressure. Shallow tumors are prone to localized abnormalities, while deep tumors are less prone to localized changes. Benign astrocytoma, oligodendroglioma, etc. The main manifestations are localized δ waves, and some epileptic waves such as spikes or sharp waves can be seen. Large glioblastoma multiforme can show a wide range of δ waves, sometimes only localized.
4. Radioisotope scanning (γ-ray EEG): A tumor with rapid growth and rich blood supply has high permeability of blood-brain barrier and high isotope absorption rate. For example, glioblastoma multiforme shows dense isotope images, and there may be low-density areas of necrosis and cyst formation in the middle, so it should be differentiated from metastatic tumors according to its morphology and multiplicity. The concentration of benign gliomas, such as astrocytomas, is low, often slightly higher than the surrounding brain tissues, and the images are not clear enough, and some of them may be negative findings.
5. Radiological examination: including head plain film, ventriculography and computed tomography. Cranial plain film can show intracranial hypertension, tumor calcification and pineal calcification displacement. Ventricular angiography can show cerebral vascular displacement and tumor blood vessels. These abnormal changes are different in different parts and types of tumors, which can help to locate and sometimes even be qualitative. Especially CT scan has the greatest diagnostic value. The accuracy of localization and qualitative diagnosis is close to 100% and 90% respectively. It can display the location, scope, shape, brain tissue reaction and ventricular compression and displacement of the tumor. However, comprehensive consideration is still needed to make a definite diagnosis.
6. Magnetic resonance imaging: Compared with CT, the diagnosis of brain tumors is more accurate, the images are clearer, and tiny tumors that cannot be displayed by CT can be found. Positron emission tomography can obtain images similar to CT, observe the growth and metabolism of tumors, and distinguish between benign and malignant tumors.
Matters needing attention in brain ultrasound examination:
1. It is not advisable to drink tea the day before the inspection, and smoking is prohibited during the inspection.
2. Patients must wash their hair to remove fat the night before the examination, and do not use hair gel or mousse.
3. Stop using vasodilators the day before the examination.
4. Before the examination, the patient should inform the examining physician of the medical history and existing symptoms in detail.
5. Keep quiet and close your eyes during the inspection.
6. After the patient's breathing and heart rate are normal, it can be checked.
7. Elderly patients should be examined one hour after meals to avoid the illusion of insufficient blood supply caused by long-term fasting.
8. If a woman has long hair, she must put it up, not up.