The department of Neuroradiology provides diagnostic examinations and therapeutic interventions of the central and the peripheral nervous systems as well as the head and neck area. There is a close cooperation with the departments of neurosurgery, neurology, psychiatry and ophthalmology but also with other departments of the Klinikum Rechts der Isar. In addition, other hospitals and medical practices from the surrounding area are consulting us in special cases. For off-time emergency patients who require an immediate interventional procedure we are offering an on call-service.

Magnet Resonance Imaging (MRI)

MRI is using electromagnetic fields and radio waves (no x-rays) to display the human body in high-resoluted slices. Not only the anatomy of the brain but also its function and its metabolism can be illustrated via MR-perfusion, MR-spectroscopy and functional BOLD-imaging. Furthermore, the vessels supplying the neck and the brain can be visualized with or without contrast-enhanced sequences. MR imaging can also be used for the evaluation of the spinal column, the spinal cord or the peripheral nervous system. For differential diagnosis the administration of an intravenous contrast agent might be necessary. The duration of an MR imaging examination lasts about 30 minutes.

Computed Tomography (CT)

CT is also a procedure displaying slices of the human body; it is based on the different absorption characteristics of tissue when X-rays are passing through the human body. CT is mainly used for visualizing bony structures (skull and spinal column) and the diagnosis of acute cerebral bleedings. Concerning soft tissue-contrast CT it is inferior to MRI. With the newest generation of equipment certain tissue functions, such as the blood circulation of the brain, can be visualized and measured. The duration of a CT examination is much shorter than in a MR imaging study, it lasts about 5-10 minutes.

Myelography

For myelographic examinations, an X-ray contrast medium is injected into the spinal fluid-filled spaces via lumbar puncture, mostly at the lumbar spine. This enables visualizing the anatomic structures indirectly, such as the spinal cord and the nerve roots on X-ray plain films and CT scans. CT-Myelography is effective in showing the anatomic relationship between pathologically altered soft-tissue structures and bony structures or spinal disks. Most frequently myelography is used for planning spinal surgery.

Angiography and Endovascular Therapy

Via angiography pathological changes of the blood vessels, such as narrowing or widening, can be shown in great detail. Neuroradiological angiography is performed, in local or general anesthesia, by inserting a thin synthetic tube (catheter) into an artery, usually in the groin. The catheter is then advanced under X-ray and contrast guidance into the arteries that supply the brain or the spinal cord. While the contrast agent flows through the vessels, digital X-rays are taken in rapid succession. After the examination the catheter is removed and a pressure bandage is placed on the groin. Various diseases of arteries and veins of the brain can be treated via the blood vessels. It is possible to widen narrowed arteries with a balloon to improve the circulation in the brain and thereby prevent stroke. Such an angioplasty can be combined with the placement of a stent. Under certain conditions cerebral aneurysms, which are distended portions of arteries, can be closed from inside the vessel by positioning flexible platinum coils. In some cases arteriovenous malformations, a tangle of abnormal cerebral vessels in which blood is directly shunted from the arteries to the veins, can be occluded or at least reduced in size by embolisation. Preoperatively, the blood supply of certain highly vascularized tumors can be reduced through the injection of particles, which affords a lower risk for an operative procedure.

Pain Therapy for the Spinal Column

Degenerative diseases of the spinal column such as disk prolapse or deterioration of the facet joints can cause severe pain. The pain can lead to tensions in the back muscles, which further increases the pain, causing a vicious circle. To treat this pain, a thin and hollow needle is introduced through the skin and the muscles to the site of the pain origin. The procedure is performed under sterile conditions and CT guidance. Then an anesthetic, usually a combination of cortisone and local anesthetic, is injected near the nerve root or the facet joint, which can eliminate or at least ease the pain.