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Showing posts with label trauma. Show all posts
Showing posts with label trauma. Show all posts

Sunday, November 11, 2007

A Simple Guide to Cerebral aneurysm

A Simple Guide to Cerebral aneurysm

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What is Cerebral aneurysm?

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A cerebral aneurysm is an abnormal ballooning of a section of a blood vessel in the brain.

What is the causes of cerebral aneurysm?

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Cerebral aneurysms occur when there is a weakened area in the wall of a blood vessel in the brain.

1.They may occur as a congenital (before birth) defect or may develop later in life.

About 5% of the population has some form of aneurysm in the brain.

2.Trauma and infection, which can injure the blood vessel wall, can cause such aneurysms.

What are the Symptoms of cerebral aneurysm?

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Cerebral aneurysm usually cause no symptoms until they rupture and cause bleeding into the brain.

Often, an aneurysm is found when a CT scan or MRI is performed for another reason. If the unruptured swollen aneurysm presses on the brain , it can cause the following symptoms:
1.Headaches

2.Eye pain

3.Neck pain

4.Double vision

5.Loss of vision

Symptoms of an aneurysm that have ruptured are:
1.Sudden occurrence of a severe headache (often described as "worst headache of my life")

2.Headaches with nausea or vomiting

3.Stiff neck

4.Muscle weakness, difficulty moving any part of the body

5.Numbness or decreased sensation in any part of the body

6.Vision changes like blurring of vision,double vision

7.Eyelid drooping

8.Confusion,

9. Sudden onset of irritability, impulsivity, or poor temper control

10.Slow, sluggish movement

11.Speech impairment

12.Seizures

A ruptured aneurysm is a medical emergency.

What are the investigations done in cerebral aneurysm?

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The following tests may be used to diagnose cerebral aneurysm:

1.CT scan of the head can identify bleeding and usually locate the aneurysm.

2.MRI of the head may be an alternative to a CT scan but may be as good at showing bleeding in the brain.

3.Cerebral angiography or spiral CT scan angiography of the head is used to pinpoint the location and size of the aneurysm.

4.cerebrospinal fluid examination via a spinal tap may confirm bleeding.

5.EEG (electroencephalogram) should be performed if there are seizures.

What is the Treatment of cerebral aneurysm?

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Symptoms often do not appear until bleeding of a cerebral aneurysm occurs.

A ruptured cerebral aneurysm is an emergency condition.

The goal of treatment is to prevent further bleeding.

Lowering of blood pressure can decrease the risk of further bleeding.

Neurosurgery is the primary treatment for cerebral aneurysm.

The base of the aneurysm is closed off with clamps or sutures.

Special coils or stents can be placed into the aneurysm through the arteries to prevent rupture.
A blood clot then forms in the aneurysm and prevents further bleeding. This is considered a less invasive approach than brain surgery. It is regarded as the best form of treatment.

If surgery is not feasible because of the location or size of the aneurysm or the condition of the person, medical treatment is:

1.restricting activity (often complete bedrest is advised),

2.treating symptoms such as headache,

3.controlling blood pressure, and

4.prescribing of antiseizure medications.

After the aneurysm is repaired, prevention of stroke due to blood vessel spasm is necessary. This may include intravenous fluids, certain medications, and controlling the blood pressure.

What is the Prognosis of cerebral aneurysm?

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The prognosis depends on the severity of the condition.
Ruptured cerebral aneurysms are often serious.

In severe cases, about 25% of people die within 1 day, and another 25% die within about 3 months. Of those who survive, more than half will have some sort of permanent disability.

In small leaks of ruptured cerebral aneurysm, early treatment of the condition can be very effective with little loss of neurological deficit.

Unruptured aneurysms can be treated very effectively before causing problems.

The decision to repair an unruptured cerebral aneurysm is based on the size and location of the aneurysm, and the patient's age and general health.

What are the Possible Complications of cerebral aneurysm?

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1.Subarachnoid hemorrhage

2.Stroke

3.Seizures, epilepsy

4.Paralysis of any part of the body

5.Permanent loss of sensation of any part of the face or body

6.Other neurologic deficits (such as vision changes, loss of speech ability, cognitive decline)

What is the Prevention of cerebral aneurysm?

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There is no known way to prevent the formation of a cerebral aneurysm because most of them are congenital.

If sudden or severe headache occurs, particularly if you also have nausea, vomiting, seizures, or any other neurological symptoms, early admission to hospital and appropriate investigation can detect an unruptured aneurym or one which has just started to bleed.

Treatment can be initiated and prognosis is good.

Thursday, September 13, 2007

A Simple Guide to Nosebleed (Epistaxis)


A Simple Guide to Nosebleed (Epistaxis)
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What is a Nosebleed?
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A Nosebleed is said to have occurred when the nose begins to bleed from the inner mucosa or lining of the nose. It does not refer to bleeding from the external skin of the nose.

What causes a Nosebleed?
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Spontaneous:
There is a layer of moist, delicate skin with a rich supply of blood vessels involving the lower front portion of the nasal septum of the nose called the Little's area. These blood vessels tend to bleed rather heavily and can be easily damaged as they are rather superficial.
Most nosebleed are anterior and may be caused by
1.irritation or dryness of the lining of the nose, which may occur with low humidity and dry environment,
2. allergic rhinitis, colds, or sinusitis.
3.Deviated septum,
4.foreign objects in the nose, or other nasal obstruction may also cause nosebleeds.

There are rare occasions whereby a nosebleed is life threatening or fatal.
In these rare cases, the bleeding is usually from a posterior nosebleed, where the site of bleeding is higher and deeper within the nose and the blood flows primarily down the back of the throat.

Underlying health conditions such as:
1.Fever,infections
2.hypertension,
3.bleeding disorder including blood cancer,
4.the use of anticoagulant medication that is often working against the clotting process.

What are the risk factors of a Nosebleed?
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The common risk factors include:
1.A hot, dry indoor climate - hot, dry air causes the delicate nasal skin to crack and bleed.
2.,Colds and allergies - Upper respiratory tract infections and allergies both trigger nasal inflammation, which can increase the risk of bleeding.
3.Exposure to irritating chemicals - Cigarette smoke, passive secondhand cigarette smoke, on-the-job exposure to sulfuric acid, ammonia, gasoline or other chemical irritants.
4.A deviated septum - A nasal septum that is deviated (shifted away from the midline) produces an uneven airflow pattern within the nostrils. The altered airflow pattern causes the skin on the nasal septum to become dry and cracked, increasing the risk of bleeding.
5. trauma, such as nose picking, forceful blowing of the nose or severe facial trauma from an automobile accident or contact sports.
6.Heavy alcohol use - Alcohol seems to interfere with the normal activity of platelets in the blood, and this increases the time needed for blood clots to form.
7.Medications that delays blood clotting - anticoagulants and nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen.
8.Medical conditions - Examples include chronic renal disease (kidney failure), thrombocytopenia (low platelets) ,leukemia,hemophilia, hereditary bleeding disorders,

What are the Symptoms of a Nosebleed?
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Symptoms include:
bleeding from one or both nostrils
frequent swallowing
sensation of fluid in the back of the nose and throat

What is the Treatment of a Nosebleed?
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Pressure & posture:
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If there is bleeding from the front of your nose, begin by trying the following first-aid measures:
Sit up, lean forward and breathe through your mouth.
Pinch the entire front of your nose, just above your nostrils, and hold it for five minutes. Apply an ice pack or a plastic bag of crushed ice to your nose to slow the blood flow.

After you have pinched your nose for five minutes, release it to see if the nosebleed continues. If your nose is still bleeding, pinch it for an additional 10 minutes. After 10 minutes, release your nose again. If you are still bleeding, seek emergency medical help. After the blood flow has stopped, try not to breathe through your nose.

If simple first aid fails, your doctor may treat the problem by:
Packing your nose with gauze
Cauterizing (sealing off) the injured blood vessel with an electric probe
Applying medication such as silver nitrate directly to the inside of your nose to stop the bleeding
Using cryotherapy (using cold temperature to freeze the site of bleeding), laser therapy (using a laser beam to seal the bleeding blood vessel)
Postnasal plugging
Surgery

What are the Prevention measures for Nosebleed?
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Here are some things you could do to prevent nosebleeding:
Not picking your nose
Being gentle when you blow your nose
Not smoking
Using a nonprescription saline nasal spray to moisturise the inside of your nose
Applying a tiny dab of petroleum jelly to the inside of your nostrils before bedtime
Avoiding facial trauma - by wearing a seatbelt in the car and by using well-fitting headgear to protect your face during contact sports
Using protective equipment to avoid breathing chemicals at work
Colds, other viruses, and allergies may also irritate the lining of the nose.

So the next time your child gets a nosebleed, try not to panic. They're usually harmless and are almost always easy to stop.

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