Another part of the neurological examination is the examination of consciousness, memory and the state of the psyche. Thus, higher brain performance such as perception and thinking can be assessed and disorders such as dementia, mental illness or consequences of organic diseases such as a stroke can be detected.
As described above, the detailed conversation already gives important hints. Speech and speech disorders can, for example, - depending on severity - on the affected brain area close. The understanding of what is spoken and written is judged by certain tests, as well as the orientation to space, time and person as well as the memory (mini-mental status test). Intelligence tests or psychological examinations such as the Rorschach test are also sometimes used.
Other methods: Imaging procedures
Often particularly interested in what is well protected behind the skull bones or vertebrae hides. For the examination of the brain and spinal cord, computer tomography (CT) is most frequently performed. Calcification, tumors, inflammations and water retention can be identified as well as bleeding and herniated discs. The bones themselves can be assessed. Conventional X-rays are therefore rarely used.
With magnetic resonance imaging (MRI), especially soft tissue, tumors and brain infarcts can be displayed very well. As with CT, certain questions can be answered by injecting a contrast agent.
The angiography serves the representation of the vessels, eg with suspicion on extensions or constrictions. For this purpose, a thin tube is advanced into the appropriate vessels, filled contrast medium and presented with a fluoroscopy.
The bloodstream itself can be made visible and audible with the help of an ultrasound examination.
Single photon emission computed tomography (SPECT) and positron emission tomography (PET) not only have complicated names, they also contain complex technology. That's why they are quite expensive to use. They use radioactive substances that are injected and their energy radiated in the body is displayed. The exciting thing is that it allows the brain to be represented during his work - active areas show more accumulation than inactive areas. So they are a popular help in brain research - which areas react when you are angry, hungry or looking at advertising? What happens when falling asleep, watching TV and learning?
Measure electrical activities
The standard examination in certain neurological diseases such as epilepsy involves the measurement of brain waves (EEG).
If one suspects that certain pathways (eg for seeing or hearing) are damaged, stimuli can be set on the periphery (eg on the eyes or ears) and the resulting activities on the brain can be measured (evoked potentials).
Electronography (ENG) measures the speed of nerve conduction. This is reduced eg in case of injuries or diseases of the nerves. For this purpose, the corresponding nerve is activated with a small current stimulus, which causes twitching of the connected muscle. It is measured how long it takes for the stimulus to arrive at the muscle.
With the electromyography (EMG) the muscle activities are made visually and acoustically visible. This can be different in muscle changes, whether the cause is the muscle itself or on this supplying nerve.
view in the future
Recently, researchers from Munich and Vienna developed a novel laser microscope. With this, a previously specially treated brain can be scanned layer by layer, and the resulting images are subsequently assembled on the computer to form a three-dimensional film. In contrast to computed tomography or magnetic resonance tomography, the layer thicknesses are not half a millimeter, but only one-thousandth of them - thin enough to be able to reconstruct individual nerve cells.
One disadvantage of this technique of simulated 3D flights through the brain, however, is that it can only be performed on dead tissue. Even if it therefore finds no place in clinical diagnostics, it opens up exciting opportunities in brain and nerve research as well as in the education of future physicians.