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Diagnosis of Neurosurgical Disease

Tests

 

Imaging - Electrophysiology  - Laboratory - Pathology

 

Workup Table

   

Workup of Neurosurgical Disease
 

After taking a history and performing a physical examination the neurosurgeon uses imaging and laboratory studies to help make a diagnosis.

Table:  Workup by Diagnosis

 

  Imaging  Electrophysiology Other physiology Laboratory Pathology

acute subdural hematoma

subdural hematoma acute no electrophysiology no other physiology no laboratory no pathology
brain death brain death radionuclide flow study Electrophysiology brain death Apnea test toxicology screen, blood gas, electrolytes no pathology

carpal tunnel syndrome

cervical disc Electrophysiology carpal tunnel no other physiology no laboratory no pathology

cauda equina syndrome

central lumbar disc   no other physiology no laboratory no pathology

cerebral aneurysm

angio aneurysm no electrophysiology no other physiology no lumbar puncture required unless CT negative no pathology

cerebral arteriovenous malformation 

Angiography remains the gold standard for imaging arteriovenous malformations 

 angiogram arteriovenous malformation AVM

no electrophysiology no other physiology no laboratory Pathology vascular malformation

cerebral glioma

intrinsic brain tumor no electrophysiology no other physiology no laboratory Pathology glioma

cervical myelopathy

cervical stenosis rule out radiculopathy no other physiology no laboratory no pathology

cervical radiculopathy

cervical disc Electrophysiology radiculopathy no other physiology no laboratory no pathology

chronic subdural hematoma

subdural hematoma chronic no electrophysiology no other physiology no laboratory no pathology

craniosynostosis

CT is the most precise imaging modality no electrophysiology no other physiology no laboratory no pathology
Cushing's disease pituitary tumor no electrophysiology no other physiology Cushing's disease laboratory Pathology pituitary adenoma

cysticercosis fourth ventricle hydrocephalus

fourth ventricle cysticercosis no electrophysiology no other physiology cysticercosis titers no pathology

increased intracranial pressure 

cerebral edema no electrophysiology ventriculostomy, parenchymal monitor, lumbar puncture no laboratory no pathology

intracranial epidural hematoma

epidural hematoma no electrophysiology   no laboratory no pathology

lumbar radiculopathy

lumbar disc Electrophysiology radiculopathy   no laboratory no pathology

aneurysmal subarachnoid hemorrhage

angio aneurysm no electrophysiology   no lumbar puncture required unless CT negative no pathology

meningioma convexity 

Radiology reports convexity meningioma no electrophysiology no other physiology no laboratory Pathology meningioma

meralgia paresthetica

  no electrophysiology   no laboratory no pathology

myelomeningocele

CT or ultrasound of head to rule out hydrocephalus no electrophysiology no laboratory no laboratory no pathology

Parkinson's

Radiology reports cranial white matter disease no electrophysiology   no laboratory no pathology
pediatric posterior fossa tumor Radiology reports pediatric posterior fossa tumor no electrophysiology  no other physiology no laboratory Pathology medulloblastoma

Pathology ependymoma

Pathology pilocytic astrocytoma

Pathology hemangioblastoma

pituitary adenoma

MR brain focus sella turcica

Radiology reports pituitary tumor

no electrophysiology no other physiology Pituitary axis-related hormones Pathology pituitary adenoma

reflex sympathetic dystrophy

  no electrophysiology no other physiology no laboratory no pathology

schwannoma brachial plexus

Radiology reports brachial plexus tumor MRI Electrophysiology brachial plexus injury no other physiology no laboratory Pathology nerve sheath tumor

temporal lobe epilepsy

Radiology reports mesial temporal sclerosis     no laboratory no pathology

trigeminal neuralgia

Radiology reports MR trigeminal neuralgia no electrophysiology no laboratory no laboratory no pathology

vertebral compression fracture

plain x-ray spine

 vertebral compression fracture

no electrophysiology no laboratory bone density no pathology

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