Symptoms of cerebrovascular (also called neurovascular) disease are often vague and mimic the symptoms of many other conditions. An accurate neurovascular disease diagnosis is the first step in getting you the help you need.

You may come to us in the emergency room or the office seeking an initial evaluation or second opinion. Wherever we perform your cerebrovascular evaluation, we leave no stone unturned to find the source of your symptoms.

Diagnosing Cerebrovascular Disease

The main imaging tests we use for diagnosing and evaluating cerebrovascular diseases include:

Magnetic Resonance Imaging (MRI) of the Brain

MRI, or magnetic resonance imaging, uses radio waves, a strong magnetic field and computer technology to create three-dimensional images of your body. It produces clear pictures of the structures of your brain and spinal cord and can detect areas of disease and damage. MRI is noninvasive, painless and does not use ionizing radiation.

Magnetic Resonance Angiogram (MRA)

MRA is a type of MRI that shows the details of the arteries in your brain. It is usually the most reliable tool for detecting abnormalities or blockages in your blood vessels. MR venography (MRV) is a similar test that looks specifically at the veins in your brain.

Computed Tomography (CT) Angiography

CT scanning uses a series of X-rays to create three-dimensional pictures. CTA is type of CT that shows the details of your arteries. In general, CTA is less sensitive than MRA but is much quicker. Neuroradiologists frequently use CTA in emergency settings to rapidly assess patients. CT venography (CTV) is a related test that evaluates your veins.

Perfusion Imaging

Perfusion imaging uses CT or MRI technology to measure blood flow to the brain. It helps doctors assess the extent of brain damage in stroke or how the brain tissue is getting its blood in moyamoya disease, for example.

Cerebral Angiogram

A cerebral angiogram is a minimally invasive test we usually do after other imaging tests show a problem. Angiograms provide the added detail often needed to diagnose complex cerebrovascular conditions and plan treatment. During this procedure, the doctor inserts a catheter into a blood vessel in your groin or wrist. They thread the catheter to the head or neck. Once the catheter is in position, they inject a contrast dye and take images. Angiogram also doubles as a type of treatment. Often we can assess the problem on the spot and perform an endovascular neurosurgery procedure right away.

Cerebrovascular Disease Diagnosis: The Penn Medicine Advantage

A physical exam and review of your medical and family history are essential to assessing your problem. But diagnostic imaging tests are the best tools to pinpoint most cerebrovascular disease diagnoses.

Our cerebrovascular disease specialists partners with the Division of Neuroradiology to offer patients advanced imaging services for the diagnosis and evaluation of neurovascular disease. Benefits of this partnership include:

  • Exceptional expertise: Our neuroradiologists know which imaging tests and protocols to use to see the blood vessels and tissues of the brain and spinal cord. This detail is critical for making a precise diagnosis and planning and evaluating treatment.
  • State-of-the-art technology: Penn’s radiology facility features the latest equipment, including numerous MRI and CT units. Our biplane angiography system is one of only a few in the U.S. This technology provides rapid, real-time imaging during an angiogram.
  • Multidisciplinary team: Our multispecialty team meets weekly to evaluate new cases and plan treatment. Neuroradiologists help interpret images and guide treatment decisions and are an essential part of the team.
  • Rapid diagnosis: Neuroradiologists are key players in the emergency room. They collaborate with other specialists on a minute-by-minute basis to quickly evaluate patients with life-threatening cerebrovascular conditions such as stroke and brain aneurysm.

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