I come across some interesting q&a sites. Check this out:
http://anatomy.med.umich.edu/nervous_system/infratemp_questions.html
Brain AVM (arteriovenous malformation)
http://brainavm.oci.utoronto.ca/malformations/brain_avm_index.htm
In arteriogram which you use to just visualize the blood vessel pattern, you would notice a mesh of blood vessels. That's what AVM is all about. It can occur anywhere and it has a certain genetic link. The condition can be silent, but when one's arterial pressure suddenly rise until the weak blood vessels can't tolerate, it will be very disastrous, especially if it occurs at the brain. The website I provided is very nice, as I found it. Should be a good reference to patients who want to know more about this condition.
I would like to share a type of scan called Diffuse Weighted Imaging (DWI)
Resources as shown below:
http://en.wikipedia.org/wiki/Diffusion_MRI
http://spinwarp.ucsd.edu/neuroweb/Text/br-710dwi.htm
A quite recent development and that very helpful in diagnosing and localizing lesions in the brain caused by insufficient perfusion to the brain region. For very technical perspective of this imaging, check this out: http://bjr.birjournals.org/cgi/reprint/77/suppl_2/S176.pdf
Some image study if you would like to know about brain aneurysm. http://www.brain-aneurysm.com/roiba.html
Wednesday, March 3, 2010
Saturday, February 27, 2010
Creutzfeldt-Jakob disease (CJD)
Creutzfeldt-Jakob disease, short-formed as CJD, is a nervous system disorder caused by prion (a kind of virus). Pathology slide of a brain infected by this disease is typically show spongiform encephalopathy, or what was called "bubble and holes".1
Of course taking a slide from a dead body is not something practical to do in terms of diagnosing a patient. Therefore, we should look for signs and symptoms as well as using a correct diagnostic tool to diagnose a case of CJD.
Just to provide a case from website about this disease: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626364/
http://en.wikipedia.org/wiki/Creutzfeldt%E2%80%93Jakob_disease
One thing I want to point out is that this disease can cause dementia. The guy can be normal, and you can confuse patient with CJD to Parkinson, like I do. Looking for signs and symptoms as the presence of myoclonus. As such, one should look for a possibility of CJD since myoclonus isn't a part of Parkinson's disease. One characteristic diagnosis we can do is an electroencephalogram showing periodic high amplitude sharp wave http://www.websciences.org/cftemplate/NAPS/archives/indiv.cfm?ID=20060373 As quoted: In sporadic CJD (sCJD), the EEG exhibits characteristic changes depending on the stage of the disease, ranging from nonspecific findings such as diffuse slowing and frontal rhythmic delta activity (FIRDA) in early stages to disease-typical periodic sharp wave complexes (PSWC) in middle and late stages to areactive coma traces or even alpha coma in preterminal EEG recordings.2
The disease can be deadly and there is no treatment for this disease.
1. Edward F. Goljan Rapid Review Pathology 2nd edi. Mosby Elsevier. 2007; 578-579
2. WIESER HG, SCHINDLER K, ZUMSTEG D. Clin Neurophysiol. 2006 [cited 2006 Jan 24] Available from: http://www.websciences.org/cftemplate/NAPS/archives/indiv.cfm?ID=20060373
Of course taking a slide from a dead body is not something practical to do in terms of diagnosing a patient. Therefore, we should look for signs and symptoms as well as using a correct diagnostic tool to diagnose a case of CJD.
Just to provide a case from website about this disease: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626364/
http://en.wikipedia.org/wiki/Creutzfeldt%E2%80%93Jakob_disease
One thing I want to point out is that this disease can cause dementia. The guy can be normal, and you can confuse patient with CJD to Parkinson, like I do. Looking for signs and symptoms as the presence of myoclonus. As such, one should look for a possibility of CJD since myoclonus isn't a part of Parkinson's disease. One characteristic diagnosis we can do is an electroencephalogram showing periodic high amplitude sharp wave http://www.websciences.org/cftemplate/NAPS/archives/indiv.cfm?ID=20060373 As quoted: In sporadic CJD (sCJD), the EEG exhibits characteristic changes depending on the stage of the disease, ranging from nonspecific findings such as diffuse slowing and frontal rhythmic delta activity (FIRDA) in early stages to disease-typical periodic sharp wave complexes (PSWC) in middle and late stages to areactive coma traces or even alpha coma in preterminal EEG recordings.2
The disease can be deadly and there is no treatment for this disease.
1. Edward F. Goljan Rapid Review Pathology 2nd edi. Mosby Elsevier. 2007; 578-579
2. WIESER HG, SCHINDLER K, ZUMSTEG D. Clin Neurophysiol. 2006 [cited 2006 Jan 24] Available from: http://www.websciences.org/cftemplate/NAPS/archives/indiv.cfm?ID=20060373
Friday, February 26, 2010
Foville's syndrome
Category: Neuroanatomy.
When one half of the pons is injured involving the corticospinal tract (above the decussation of the pyramids), the facial nerve (CN VII) nucleus and/or facial nerve fibers, and the nucleus of CN VI (abducens) or the nearby paramedian pontine reticular formation (PPRF) fibers to CN VI, the resulting constellation of signs/symptoms includes: contralateral spastic weakness/paralysis (weakness, hypertonia, hyperreflexia and Babinski's sign), ipsilateral upper and lower facial weakness and loss of volitional abduction of the ipsilateral eye (horizontal gaze paresis).
From: http://en.wikipedia.org/wiki/Foville's_syndrome
Foville's syndrome is caused by the blockage of the perforating branches of the basilar artery in the region of the brainstem known as the pons.[1]
Structures affected by the infarct are the PPRF, nuclei of cranial nerves VI and VII, corticospinal tract, medial lemniscus, and the medial longitudinal fasciculus.
The syndrome is reported in http://www.nzma.org.nz/journal/119-1232/1928/ in which the case mentioned the syndrome on a suspected Wernicke’s encephalopathy.
There is another recorded case: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1143046/
When one half of the pons is injured involving the corticospinal tract (above the decussation of the pyramids), the facial nerve (CN VII) nucleus and/or facial nerve fibers, and the nucleus of CN VI (abducens) or the nearby paramedian pontine reticular formation (PPRF) fibers to CN VI, the resulting constellation of signs/symptoms includes: contralateral spastic weakness/paralysis (weakness, hypertonia, hyperreflexia and Babinski's sign), ipsilateral upper and lower facial weakness and loss of volitional abduction of the ipsilateral eye (horizontal gaze paresis).
From: http://en.wikipedia.org/wiki/Foville's_syndrome
Foville's syndrome is caused by the blockage of the perforating branches of the basilar artery in the region of the brainstem known as the pons.[1]
Structures affected by the infarct are the PPRF, nuclei of cranial nerves VI and VII, corticospinal tract, medial lemniscus, and the medial longitudinal fasciculus.
The syndrome is reported in http://www.nzma.org.nz/journal/119-1232/1928/ in which the case mentioned the syndrome on a suspected Wernicke’s encephalopathy.
There is another recorded case: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1143046/
Sunday, January 17, 2010
Happy New Year 2010
I just realized I made this blog idle for quite some time (My bad). Therefore I would like to just write an entry wishing all a wondeful new year of 2010. Hope everyone will have a good time this year, ya?
Wednesday, November 25, 2009
Sucking Chest Wound
http://www.brooksidepress.org/Products/OperationalMedicine/DATA/operationalmed/Procedures/TreataSuckingChestWound.htm
I was looking at a statement talking about sucking chest wound.
The statement as shows: First aid for sucking chest wound is with occlusive dressing that allows air out (taped on three sides) but not in.
I didn't quite get it. Just imagine one day, you are walking in an American street and you witnessed a gun fight. Someone got shot on the chest. In such scenario, let's just test how much knowledge you know for this scenario ya? By the way, the above statement was from Kaplan Surgery CK 2008-2009. For the pictures, just go and visit the html at the top of the post.
A sucking chest wound is identified by the sucking or hissing sound made during breathing by the casualty.
With this type of wound, the chest cavity is no longer sealed, allowing air to rush through the wound and into the chest during inhalation. This causes the lung to collapse. This is a life-threatening condition and requires immediate treatment.
Start by uncovering the wound. If the clothing is stuck to the wound or in a chemical environment, then clothing should not be removed. Don't attempt to clean the wound. That will be done later.
Use the casualty's hand to cover the wound while you quickly prepare an occlusive patch. The plastic wrapper of a battle dressing works very well, although any air-tight material can be substituted, such as:
Cellophane
Aluminum foil
Duct Tape
Vaseline Gauze
The patch should be large enough to extend 2 inches beyond the edge of the wound. Smaller patches tend to get pulled back into the wound.
Secure the patch to the wound with adhesive tape. Three sides should be taped, while the 4th side is left untaped. Whenever the casualty breaths out (exhales), air is expelled from the chest cavity and escapes from underneath the open edge of the patch. Whenever the casualty breaths in (inhales), the patch sticks to the skin and keeps air from returning into the chest cavity. This helps to re-inflate the collapsed lung.
Place a small battle dressing over the patch, but don't make it so tight that the casualty can't breath.
Sometimes, you won't have any adhesive tape, or the tape won't stick (blood, water, mud, or perspiration may keep it from sticking). In that case, it is still very helpful to use the patch, held in place by a battle dressing or triangular bandage.
Finally, roll the patient onto the injured side while awaiting transportation.
Some medical bags include pre-packaged chest seals. These are easy to use and fast.
· Use the enclosed gauze pad to wipe the skin dry around the wound.
· Peel off the paper backing and place the sticky side of the seal over the wound and surrounding skin
· The one-way flutter valve will allow air to be expelled from the chest, but will keep the outside air from returning.
I was looking at a statement talking about sucking chest wound.
The statement as shows: First aid for sucking chest wound is with occlusive dressing that allows air out (taped on three sides) but not in.
I didn't quite get it. Just imagine one day, you are walking in an American street and you witnessed a gun fight. Someone got shot on the chest. In such scenario, let's just test how much knowledge you know for this scenario ya? By the way, the above statement was from Kaplan Surgery CK 2008-2009. For the pictures, just go and visit the html at the top of the post.
A sucking chest wound is identified by the sucking or hissing sound made during breathing by the casualty.
With this type of wound, the chest cavity is no longer sealed, allowing air to rush through the wound and into the chest during inhalation. This causes the lung to collapse. This is a life-threatening condition and requires immediate treatment.
Start by uncovering the wound. If the clothing is stuck to the wound or in a chemical environment, then clothing should not be removed. Don't attempt to clean the wound. That will be done later.
Use the casualty's hand to cover the wound while you quickly prepare an occlusive patch. The plastic wrapper of a battle dressing works very well, although any air-tight material can be substituted, such as:
Cellophane
Aluminum foil
Duct Tape
Vaseline Gauze
The patch should be large enough to extend 2 inches beyond the edge of the wound. Smaller patches tend to get pulled back into the wound.
Secure the patch to the wound with adhesive tape. Three sides should be taped, while the 4th side is left untaped. Whenever the casualty breaths out (exhales), air is expelled from the chest cavity and escapes from underneath the open edge of the patch. Whenever the casualty breaths in (inhales), the patch sticks to the skin and keeps air from returning into the chest cavity. This helps to re-inflate the collapsed lung.
Place a small battle dressing over the patch, but don't make it so tight that the casualty can't breath.
Sometimes, you won't have any adhesive tape, or the tape won't stick (blood, water, mud, or perspiration may keep it from sticking). In that case, it is still very helpful to use the patch, held in place by a battle dressing or triangular bandage.
Finally, roll the patient onto the injured side while awaiting transportation.
Some medical bags include pre-packaged chest seals. These are easy to use and fast.
· Use the enclosed gauze pad to wipe the skin dry around the wound.
· Peel off the paper backing and place the sticky side of the seal over the wound and surrounding skin
· The one-way flutter valve will allow air to be expelled from the chest, but will keep the outside air from returning.
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