Skull X-Ray (skull radiography) is the study of the bone structures of the skull using X-ray radiation. It allows to diagnose acquired and congenital deformities of the skull bones, the consequences of surgical interventions and traumatic injuries. Soft tissue formations (abscesses, tumors) and brain tissues are practically not visible on radiographs, but the presence of pathological processes and the state of brain tissues in some cases can be indirectly determined by changes in the bones of the skull.
Indications
In neurological practice, radiography of the skull is used to diagnose developmental abnormalities, injuries and inflammatory processes in the area of the skull bones. Craniography is performed to detect primary neoplasms, metastases, myelomas in the bones of the skull and the sella turcica.
- the destruction of the back of the sella turcica indicates the presence of a pituitary tumor
- the deformation of the optic canal indicates a neoplasm of the optic nerve
- the expansion of the internal auditory canal in the pyramid of the temporal bone is about the neurinoma of the auditory nerve.
The tumor process in the brain substance can be judged by changes in the bones (usura, hyperostosis, vascular furrows) adjacent to the affected area, and the presence of calcification foci in the brain tissue.
With the help of radiography of the skull, pronounced intracranial hypertension is diagnosed, in which the size of the skull increases, its base becomes flatter, and so-called “finger indentations” appear on the inside of the bones of the arch. It should be noted that due to the appearance of modern diagnostic methods, the use of skull radiography in neurology is gradually becoming more and more limited.
Contraindications
Radiography is not prescribed during pregnancy and in childhood (except in cases when the study is carried out for vital indications). As contraindications, a serious condition of the patient is considered, requiring the use of life support equipment. It is impractical to conduct X-ray of the skull in excited patients, since their motor activity makes it impossible to obtain high-quality images. In such cases, they resort to the appointment of sedatives or the use of short-term anesthesia.
Methodology of conducting
Before the examination, the patient should remove all metal and hard objects from the neck and head: hairpins, earrings, chains, etc. The sequence of the study is similar to any radiography. At the same time, due to the complex anatomical structure of the skull, various styling has to be used to study it, which can cause certain inconveniences to the patient.
The patient may be assigned a standard technique, including survey images in 2 projections, or targeted radiographs of the sella turcica, orbits, temporal bones. To obtain high-quality images, the head is fixed in the desired position with the help of special bandages, sandbags or foam pads. When examining weakened patients, sometimes the participation of a nurse is required, who helps the patient fix the head.
