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Neurology · Additional Topics

Diagnostics of nervous system diseases

Neurologica diagnostica

Diagnosis of nervous system diseases is based on a combination of clinical examination, history taking, and modern neuroimaging methods. Instrumental studies, such as CT, MRI, and angiography, allow for the precise identification of pathological foci, vascular anomalies, and inflammatory processes.

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Neuroimaging methodsBrain and spinal cord CT and MRI
Cerebrospinal fluid analysisLumbar puncture in inflammation and SAH
Vascular monitoringAngiography for aneurysm detection
Pain criteriaAssessment of tender points and attack frequency
2 min readFor medical studentsUpdated 10.10.2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesPending instructor review

Acute vascular events and intracranial hemorrhages

Diagnosis of acute conditions, such as subarachnoid hemorrhage, requires emergency measures. The main tools here are computed tomography (CT) and lumbar puncture. To detail vascular pathology, for example, in the rupture of an internal carotid artery aneurysm in the region of origin of the posterior communicating artery (a. communicans posterior), angiography is used.

In turn, chronic subdural hematoma develops in the space between the dura mater (dura mater) and the arachnoid mater (arachnoidea mater). Its source is often the cortical bridging veins, and in the chronic phase, granulation tissue forms, sustaining the process.

Inflammatory and infectious lesions of the CNS

Spinal cord and peripheral nervous system lesions require an integrated approach:

  • Transverse myelitis: Focal inflammation of several spinal cord segments is diagnosed based on the clinical picture following an infection, cerebrospinal fluid changes (lymphocytic pleocytosis, normal glucose), and spinal cord MRI data (T2-weighted changes).
  • Lyme disease (borreliosis): A vector-borne disease transmitted by an ixodid tick bite. In addition to skin manifestations (erythema migrans), it can cause meningoencephalitis and cranial nerve neuritis.
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Diagnosis of pain syndromes and headaches

Many common conditions are diagnosed primarily on the basis of clinical criteria and medical history:

  1. Tension-type headache (TTH): Diagnosed when there are at least 10 attacks over 3 months. Palpation reveals tenderness of the pericranial muscles. Instrumental methods (CT or MRI) are prescribed only for an atypical presentation.
  2. Fibromyalgia: Characterized by diffuse pain and the presence of tender points. To confirm the diagnosis, tenderness must be detected in at least 11 out of 18 specific points symmetrically across the body.

Instrumental studies in back pain

In cases of nonspecific neck and back pain, radiography, CT, or MRI of the spine are not required in most cases. They are prescribed exclusively for differential diagnosis to rule out tumors, inflammation, lumbar stenosis, or spondylolisthesis. At the same time, discogenic radiculopathy requires mandatory confirmation of a herniated intervertebral disc using neuroimaging.

How to memorize

For TTH, remember the "10-3-15" rule: from 10 attacks over 3 months, and the chronic form is from 15 times a month.

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What else to study on this topic

  • Endovascular coiling treatment methods for aneurysms
  • Pathogenesis of granulation tissue in chronic hematomas
  • Cerebrospinal fluid parameters in transverse myelitis
  • Symptomatology and cranial nerve lesions in Lyme disease
  • Differential diagnosis of episodic and chronic forms of TTH

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Other topics in the "Additional Topics" section

Blood supply to the spinal cordClassification of vascular diseases of the nervous systemChronic cerebral ischemiaTransient cerebrovascular accidentsCerebral artery syndrome lesionsVascular diseases of the spinal cord

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