To teachers who introduce patients

At the Okurayama Neurosurgical Clinic, we provide medical care and examinations for patients introduced by regional medical institutions.
Regardless of neurosurgery, we also accept requests for various imaging tests in each clinical department area.

For the image inspection you requested, we will make full use of the highest standard equipment and provide the inspection results to help the teachers' diagnosis. We will also cooperate with regional medical institutions to provide medical support to your patients.

Inspection request form

If you do not have the inspection request form of our hospital, please download the PDF file of the inspection request form on the right.

You can also print the PDF file inspection request form with a printer that can be printed on a PC by clicking the print icon in the upper frame of the PDF.

If you contact the general affairs of this hospital from the teachers who are considering the inspection request continuously, we will send you the inspection request form. Please tell us.

 
 
Inspection request procedure

① Make a reservation for inspection

When you make an examination reservation from a medical institution

 Please call.

(2) When the appointment date and time for the examination has been decided and you have finished the call, please enter the appointment date and time for your visit and the following items.
Patient name, date of birth, gender, name of your hospital, name of doctor requested, telephone number of your hospital, equipment to be examined, presence or absence of contrast

 

③ Please check the items to be checked before the inspection and fill them out.

For contrast examination, please describe renal function.

 

④ Please enter the test site, disease name or purpose of clinical diagnosis / test.

Please fill in if you have any requests such as shooting method and image processing method.

 

⑤ Please give the patient the 2nd and 3rd examination reservation slips. 

When a patient makes an appointment for an examination

 Please tell us to call.

Reservation for inspection

① Please decide the contents of the examination during the examination and fill in the following items on the letter of introduction.
Patient name, date of birth, gender, name of your hospital, name of doctor requested, telephone number of your hospital, equipment to be examined, presence or absence of contrast

(2) Please check the items to be checked before the inspection and fill them out.

For contrast examination, please describe renal function.

③ Please enter the test site, disease name or purpose of clinical diagnosis / test.

If you have any requests such as the date of your next medical examination, shooting method, image processing method, etc., please fill in.

④ Please give the patient the 2nd and 3rd examination reservation slips.  

⑤ Please explain to the patient to look at the third sheet and make an appointment for the examination.

 
Contrast agent information and precautions
 

MRI contrast agent

Name of chemical used

  Gadovist (gadolinium preparation): Intravenous administration (Bayer Yakuhin, Ltd.)

  Magnescope (gadolinium preparation): intravenous administration (Fuji Pharma Inc.)

  EOB Primovist (gadolinium preparation): Intravenous administration (Bayer Yakuhin, Ltd.)

  Bosdel (manganese chloride tetrahydrate): Oral administration (Kyowa Fermentation Kirin Co., Ltd.)

About side effects

  Mild side effects such as nausea and vomiting are seen in less than 0.1-5%.

  In addition to the above symptoms, oral contrast media causes loose stools, (5%) diarrhea, and abdominal pain (0.1-5%).

  There is a possibility.

CT contrast agent

The Okurayama Neurosurgical Clinic is not currently conducting CT contrast examinations.

CT contrast examination will be handled at Koyasu Neurosurgical Clinic.

For reservations for CT contrast examination , please contact Koyasu Neurosurgical Clinic 045-360-1123.