The cranial base is the point where all of the critical blood vessels and nerves enter and exit the skull. It is one of the most delicate and complex areas of the human body. Diseases of this region include tumors and defects from trauma or present since birth. Symptoms of conditions in the skull base are location-specific and will very much depend upon the surrounding structures that are invaded or compressed by a tumor. Thus, pituitary tumors can cause partial blindness and hormonal dysfunction. Acoustic neuromas can produce deafness, facial paralysis and body weakness.
Diagnosis of a skull base disorder begins with a complete history and full neurological examination. A detailed description of signs and symptoms along with time and duration of onset helps to determine urgency for treatment. Diagnostic tests, including CT scans and MRIs, are required on almost all cases. Additional modalities such as angiography (traditional digital subtraction and CT angiography) might also be required if critical vascular structures are near to the area in question.
We also have access to more advanced MR imaging techniques including functional, perfusion, and quantitative flow studies, if the proper treatment requires this information. In case of cerebrospinal fluid (CSF) leak, injection of dye through a lumbar puncture might also be necessary to locate the site of leakage.
Ultimately, a tissue sample obtained through surgery is the only way to confirm a diagnosis.
The cranial base is the point where all of the critical blood vessels and nerves enter and exit the skull. It is one of the most delicate and complex areas of the human body. Diseases of this region include tumors and defects from trauma or present since birth. Symptoms of conditions in the skull base are location-specific and will very much depend upon the surrounding structures that are invaded or compressed by a tumor. Thus, pituitary tumors can cause partial blindness and hormonal dysfunction. Acoustic neuromas can produce deafness, facial paralysis and body weakness.
Diagnosis of a skull base disorder begins with a complete history and full neurological examination. A detailed description of signs and symptoms along with time and duration of onset helps to determine urgency for treatment. Diagnostic tests, including CT scans and MRIs, are required on almost all cases. Additional modalities such as angiography (traditional digital subtraction and CT angiography) might also be required if critical vascular structures are near to the area in question.
We also have access to more advanced MR imaging techniques including functional, perfusion, and quantitative flow studies, if the proper treatment requires this information. In case of cerebrospinal fluid (CSF) leak, injection of dye through a lumbar puncture might also be necessary to locate the site of leakage.
Ultimately, a tissue sample obtained through surgery is the only way to confirm a diagnosis.
