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Properly evaluating skull base conditions and getting the best possible preoperative and intra-operative imaging is of the utmost importance. Diagnosing skull base disorders starts with a physical exam including questions about your symptoms and personal and family health history. A neurological exam will check your vision, hearing, balance, coordination, reflexes and ability to think and remember. Diagnostic imaging is then ordered to get good views of your brain.

The Center for Cranial Base Surgery is backed by the most advanced, state-of-the-art neurodiagnostic imaging facilities in the region that includes sub-specialty trained, board-certified radiologists who perform extensive diagnostic studies and therapeutic procedures.

Diagnostic Tools for Skull Base Disorders

Magnetic Resonance Imaging (MRI): An MRI is a diagnostic test that produces three-dimensional images of body structures using magnetic fields and computer technology. It produces very clear images of various types of nerve tissue and clear pictures of the brain stem and posterior brain. MRI of the brain can help determine many disorders including whether there are signs of prior mini-strokes. 

Computed Tomography (CT or CAT scan): A CT scan uses a combination of X-rays and computer technology to produce images of the brain. A CT scan shows structures of the brain and evaluates for the presence of mass, fluid collection and/or signs of a stroke. 

Bone Scan: This procedure entails injecting radioactive material into your bloodstream. The tumor absorbs the material and a special camera is used to produce an image using a computer. This way your doctor can locate the bone tumor and detect any spread of cancer into other organs.

Positron Emission Tomography (PET): A PET scan can detect changes in cells as they grow. Often used in conjunction with a CT, a PET/CT identifies tumor cells injected with a radioactive glucose so they can be compared with normal parts of the brain.

Intraoperative Advanced Imaging Technology

TumorGlow®: TumorGlow® is a type of interoperative molecular imaging that relies on an injectable dye that has been specially engineered to accumulate in cancerous tissues, much more so than in normal tissues. It also enables previously unattainable levels of precision during resection.

3D Endoscopy: Provides three dimensional visualization, improving depth perception during evaluation and surgery.

Neuroradiologic Mapping: Produces highly precise clinical imaging of advanced tumors within the central and peripheral nervous system, using both MRI and CT to best define tumors of the skull base and rule out anomalies that will not require surgery.

Interventional Angiography: Defines critical vascular structure and decrease blood loss during certain procedures, used to block off blood vessels to a tumor as well as provide critical analysis to determine if the pituitary gland is the cause of the Cushing’s symptoms (Inferior petrosal sinus sampling).

Cranial Nerve Monitoring: Used during surgery to identify and preserve vision, hearing, balance and facial expressions, as well as speech and swallowing.

Intraoperative Computer-Assisted Navigation: Used to identify the precise location of tumors in relation to surrounding vital tissues.

Second Opinion for Skull Base Tumors

There are many decisions to make and many feelings to process when you've been diagnosed with a skull base tumor. Many individuals seek a second opinion from Penn's neurosurgeons to help decide what the best treatment might be. During a second opinion, a Penn neurosurgeon will review your medical history, current diagnosis and any images that have been taken. It is very important to bring all images, regardless of how long ago they were taken. This will help us determine the tumor's location and growth over time.

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