The Cerebellum and Brainstem

Cerebellum

• Located at the back of the head, below the temporal and occipital lobes and above the brainstem
• Has two hemispheres, with neurons in the outer portion and communication with the cerebral cortex in the inner area

Brainstem

Midbrain

• Complex structure with various neuron clusters, neural pathways, and other structures
• Facilitates functions such as hearing, movement, calculating responses, and environmental changes

Pons

• Origin of four of the 12 cranial nerves, enabling activities like tear production, chewing, blinking, and facial expression
• Connects the midbrain and the medulla

Medulla

• Located at the bottom of the brainstem, where the brain meets the spinal cord
• Essential for survival, regulating bodily activities like heart rhythm, breathing, blood flow, and oxygen/carbon dioxide levels
• Produces reflexive activities like sneezing, vomiting, coughing, and swallowing

Spinal Cord

• Extends from the bottom of the medulla and through the bottom of the skull
• Supported by the vertebrae, carries messages to and from the brain and the rest of the body

Brain Hemisphere

Frontal Lobe

• Largest lobe of the brain, located in the front of the head
• Involved in personality characteristics, decision-making, and movement

Parietal Lobe

• Middle part of the brain, helps identify objects and understand spatial relationships
• Involved in interpreting pain and touch in the body

Cerebral Angiogram

• Diagnostic procedure to reveal issues with brain blood vessels
• Performed in an operating room by specially trained healthcare providers
• Also known as digital subtraction angiography (DSA) or computed tomography angiography (CTA)

Venography

• Types include:
  • Ascending venography: looks for deep vein thrombosis (DVT)
  • Descending venography: checks deep vein valves
  • Venography of the upper extremities: looks for blockages or vascular problems
  • Venacavography: examines the inferior or superior vena cava

Anatomy of the Brain

• Cerebrum: largest part of the brain, comprising gray matter (cerebral cortex) and white matter at its center
• Initiates and coordinates movement, regulates temperature, and enables speech, judgment, thinking, and reasoning

Patient Preparation

• Medical history (dealing with vessels and clotting)
• Explain procedure (informed consent)
• Vital signs checked (constantly monitoring)
• Contrast media
• Patient NPO and sedate
• Skin prep
• Consent form (informed)
• Assess pulses bilaterally (before the procedure)

Use of Contrast

• Contrast material injected into blood vessels and CT scanning to diagnose and evaluate blood vessel disease
• Tell your doctor about possible pregnancy, recent illnesses, medical conditions, medications, and allergies
• No eating or drinking several hours beforehand

Patient Positioning

• Supine position: face up with head resting on a pad positioner or pillow and neck in a neutral position
• Arms maintained in a neutral thumb-up or supinated position, tucked at sides or abducted to less than 90 degrees on armboards