Migraines, Headaches
Patient Education

Sedimentation Test (ESR)

Indicates:

• inflammation
• treatment efficacy
• disease progression

After a tourniquet is applied to the upper arm, the puncture site of skin is swabbed with alcohol pads and a needle punctures the skin. Blood is then drawn into a syringe for analysis.

The test tube that received the blood is assessed in one hour. The more red blood cells that settle into the bottom of the tube, the higher the sedimentation rate and the higher the inflammation.

Under Age 50

(in mm/hr)

Men: 0-15

Women: 0-20

Over Age 50

Men:0-20

Women: 0-30

Lumbar Puncture (spinal tap)

Purpose is to:

• Find symptom caused by infection (e.g. meningitis), cancer or hemorrhage
• Measure pressure surrounding the spinal cord
• Diagnose conditions of the nervous system (e.g. multiple sclerosis or Guillain-Barre syndrome)
• Inject pain medication into the spinal cord
• Inject therapeutic drugs to treat cancer and leukemia

You will lie on the bed in a fetal position or leaning forward while sitting on a chair with head and chest tucked in toward your knees.

The back is cleaned with alcohol and draped with sterile pads or towels. Local pain medication is injected into the site for puncture.

A long (spinal) needle is inserted into the spinal canal and once in place, the solid core of the needle is withdrawn. If no spinal fluid is obtained, another puncture site may be used.

A device called a manometer is attached to the needle measuring the CSF. After fluid samples are obtained, the needle is removed and the site is cleansed and bandaged.

Color: clear

Pressure: 90-180 mm

Organisms: None

RBCs: None

WBCs: 0-5/mm cubed

Protein:15-45 mg/dL

Glucose: 60% of blood glucose

Magnetic Resonance Imaging (MRI)

Looks for:

• Hydrocephaly (water on the brain)
• Tumors
• Abscess
• Abnormalities of nerves to eyes and ears
• Pituitary gland problems
• Symptoms of head injury
• Aneurysms
• Blood flow, clots or active bleeding in the brain
• Signs of stroke

You will be asked to remove all jewelry, dentures, clips, artificial limbs, braces, hairpins, hearing aids

You will then lie on the table (possibly having received sedation) which slides into a tunnel-like space.

Earplugs or headphones with music may be given to mask the tapping noises during the scan.

If needed, contrast material may be given in the IV line inserted into a vein.

No visualization of growths, tumors, bleeding.

No signs of inflammation.

No abnormalities of the brain, nerves, and surrounding areas.

CT Scan

Looks for:

• Looks for:
• Brain tumors
• Ruptured aneurysms
• Abnormalities of sinuses
• Foreign objects
• Broken bones
• Eye and optic nerve problems
• Auditory nerve and middle ear problems
• Abnormalities of facial, jaw and skull bones and joints

You will be asked to remove jewelry, hearing aids and glasses.

You will lie on a table and straps will be applied to your head to keep it steady. Sedation may be given.

The table slides into a round opening of the scanner, which then moves around your body, taking pictures. Buzzing can be heard during this process.

If contrast material is needed, it will be inserted into an IV in a vein (of the arm or hand)

The test takes 30 min.

Images show no bleeding,

No foreign objects, no tumors or growths, no fractures.

The skull, face, joints, jaw are normal in shape, size and position.