AIIMS November 2011 – MCQ 200
A patient had a history of trauma to the eye 2 months back. Now he presents with ocular damage and multiple cranial nerves involvement. Which of the following is the investigation of choice?
A. MRI
B. CT
C. DSA
D. MRA
Please contribute to the discussion by posting the answer with references and pointing out the errors in the question!
6 Comments
Cul
Intra-Arterial Digital Subtraction Angiography (DSA)-Multi-slice CTA should be performed in isolated third nerve palsy (except for patients with NID/CED). If CTA is negative, DSA is indicated for patients with CID and for patients with PID/CED except men 50-years old. DSA is not indicated for patients with NID/PED except those with superior division palsy or < 50-years old.
[complete (C), partial (P) or no (N) internal (I) dysfunction (D) and C or P external (E) dysfunction]
http://www.abstracts2view.com/aan2007boston/html/P01.154.html
When evaluating a patient that may have sustained an orbital fracture, order a CT scan (not MRI as it is not as sensitive as CT for looking at bony tissue) of orbits and brain with 3-mm cuts generally being sufficient. A broad-spectrum oral antibiotic should be prescribed for 10 to 14 days to avoid orbital cellulitis. Instruct the patient not to blow their nose and use a cold compress for 24 to 48 hours. Immediate consults are only necessary for an orbital roof fracture (neurosurgical consult) or a trapdoor fracture (oculoplastics consult). Get an oculoplastics consult in up to 7 to 14 days for a large fracture or cosmetically unacceptable enophthalmos, and up to 3 to 6 weeks for persistent diplopia. All other patients should be followed periodically and tend to recover without surgical intervention.
http://www.pacificu.edu/optometry/ce/courses/21042/primarycaretraumapg2.cfm
So answer would be CT
mri
DSA… DSA is superior to MRA when the intracranial vessels are to be visualised.
ans:DSA