Craniocorpography

Craniocorpography (CCG) is a diagnostic procedure used in neurootology and occupational medicine that was developed to assess balance dysfunction. Vestibulo-spinal balance testing using craniocorpography provides both the ability to measure and evaluate balance testing in a largely objective and quantifiable manner.

Indication (indications for use)

The procedure of craniocorpography is used for neurootological diagnostics, primarily within the professional association guideline G-41 “Work involving a risk of falling” as an examination method. Craniocorpography is thus intended for workplaces with an increased risk of falling.

Contraindications

In acute diagnostics, for example, in the context of a brainstem or cerebellar infarction, the use of craniocorpography is not indicated because primary imaging techniques are used for (immediate) diagnosis.

Before the procedure

Because craniocorpography is a noninvasive procedure, no other measures are necessary before performing craniocorpography. However, it is important to verify that the indication for the use of craniocorpography is correct.

The procedure

To perform and evaluate craniocorpography, a helmet with two lamps is worn by the respective patient during the examinations, with two additional lamps attached to the patient’s shoulders. With the help of a camera located above the patient, the movement patterns can be precisely recorded and subsequently assessed. The craniocorpography procedure represents a method in which the following clinical examination procedures are assessed:

  • Unterberger treading test – To perform this method, the patient is asked to tread in place 50 times with eyes closed. The finding is considered positive (clinically striking) if the patient rotates more than 45 degrees on his or her own axis during the course of the procedure. A positive test is indicative of a cerebellar lesion or damage to the vestibular organ (organ of balance in the ear).
  • Romberg standing test (synonyms: Romberg test; Romberg test) – The Romberg standing test is used as a clinical test to investigate ataxia (vestibular, spinal (spinal cord), or cerebellar (cerebellum)) and can help differentiate between spinal and cerebellar ataxia. To perform it, the patient is asked to stand with feet close together and arms outstretched and eyelids closed. A positive finding (= positive Romberg sign) denotes a deterioration in coordination due to closure of the eyelids. A sign of deterioration is an increasing swaying, which would be indicative of spinal ataxia. A negative finding indicates unchanged coordination after eye closure.
    • If the patient can control sway only incompletely or not at all, even with eyes open, this is indicative of cerebellar ataxia.
    • A tendency to fall in one direction after eye closure would speak for damage to the respective vestibular organ.
  • LOLAVHESLIT test – The name of this method represents an acronym for the “Longitudinal, Lateral, Vertical Head-Sliding Test”, which can be used to assess pathological processes related to the cervical vertebrae, spine and movement disorders of the neck.
  • NEFERT Test – The acronym stands for “Neck Flexion Rotation Test,” and the method is used to diagnose intra-body movement differences between the head and the rest of the body, particularly at the upper cervical joint and the lower cervical spine. The diagnostic utility of this method is in the detection of sprains of the neck, as well as the diagnosis of a “stiff neck” and co-assessment of whiplash.
  • WOFEC test – This acronym stands for “walk on floor eyes closed”, and this test method can be used for additional assessment of ataxia.

After the procedure

Following the performance and evaluation of craniocorpography, other procedures must be used depending on the test results. If the findings are pathologic, imaging by magnetic resonance imaging (MRI) or computed tomography (CT) of the skull or spinal canal is usually necessary.