Clinical Services

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  • Diagnostic Services

    In keeping with the focus on early intervention, the UMMC Neurovascular (Stroke ) Group's diagnostic facilities are focused on early recognition using the most up-to-date imaging modalities.

    The following imaging modalities are available:

    • Computed tomography (CT) is often used to quickly distinguish between a hemorrhagic and ischemic stroke. This is critical when planning early intervention. Rapid spiral scanning is available at UMC to obtain extremely rapid studies. The Medical Center maintains two state-of-the-art CT scanners and is in the process of adding a third machine. The new CT angiography technology is also in use.
    • Magnetic resonance imaging (MRI) is a useful study for precisely locating the stroke and determining the extent of the ischemic or hemorrhagic stroke. It also allows for precise delineation of a variety of pathologic lessons in the brain and spinal cord that can lead to stroke.
    • Magnetic resonance angiography/venography (MRA/MRV) is a non-invasive imaging technology for visualization of cerebral vasculature. It also allows measurement of flow in major intracranial and extracranial vessels.
    • Duplex Doppler scanning of the carotid artery is an ultrasound imaging technique that helps to determine with high sensitivity and high specificity whether extracranial arteries are narrowed or occluded and at risk of causing stroke.
    • Transcranial Doppler (TCD) is another ultrasound procedure that allows for assessment of blood flow velocity through the intracranial vessels (e.g., middle cerebral artery) This is also a very useful technique for detecting vasospasm in patients who have suffered a subarachnoid hemorrhage, embolism, or carotid dissection. Because the TCD unit is portable, the test may be performed at the patient's bedside.
    • Cerebral angiography remains the gold standard for diagnosis of arterial occlusions, stenoses, arterial dissections, aneurysms, AVMs, and other vascular abnormalities.

    Other diagnostic services include: 

    • Radionuclide SPECT scanning provides data on relative blood flow using the radionuclide Technetium-99. The procedure is well tolerated by most patients. This test may be also utilized in conjunction with balloon test occlusion of the internal carotid artery for the management of complex vascular lesions.
    • Interventional magnetic resonance imaging (IMRI) - UMMC has been a leader in developing the neurosurgical applications of IMRI technology including its use in the management of complex vascular disorders. IMRI provides information regarding the anatomy of the brain and cerebral vessels to the surgeon in virtual real-time.
    • Hematologic evaluation services - UMMC's comprehensive screening services include testing for hematologic abnormalities including problems with excessive clotting, or those related to abnormal bleeding. Screening is provided for hematologic risk factors such as hyperlipidemia, anticardiolipin antibodies and hypercoagulable states which are associated with stroke.
    • Cardiac evaluation services - Approximately 20 percent of strokes are due to cardiogenic causes such as atrial fibrillation, myocardial infarction and valvular abnormalities. UMMC offers modern cardiac evaluation modalities including transesophageal echocardiography.
    • Neuro-ophthalmology services - A significant number of patients who suffer a stroke experience visual impairment. UMMC offers a comprehensive neuro-ophthalmologic evaluation as part of the UMMC Stroke Group.