Categories
Disease

Types and Causes of Migraine | Neurology

What is a migraine?

Migraine is a neurological circumstance that can cause several symptoms. It is often identified by severe and weakening headaches. Symptoms can include nausea, vomiting, slurred speech, numbness or tingling, and sensitivity to light and sound. These are often hereditary and distress people of all ages.

The diagnosis of migraines is firmly based on medical history, listed symptoms, and decision out other causes. The most common categories of migraines are those without aura (formerly known as common migraines) and those with aura (formerly known as classic migraines).

This can start in childhood or not occur until early adulthood. Females are more likely than males to have migraines. Family history is one of the most communal risk factors for migraines.

Types of migraine

There are several types of migraines. The most common are migraines with aura (also known as classic migraine) and migraines without aura (or common migraine).

Other types include:

  • Menstrual migraine: This is when the headache is related to the woman’s period.
  • Silent migraine: This type is also known as acetic migraine. You have aura symptoms without a headache.
  • Vestibular migraine: You have stability problems, vertigo, nausea, and vomiting, with or without a headache. This type typically occurs in people who have a history of motion sickness.
  • Abdominal migraine: Experts don’t know much about this guy. It causes stomach pain, nausea, and vomiting. It often occurs in children and can develop into classic migraine headaches over time.
  • Hemiplegic migraine: You have a brief period of paralysis (hemiplegia) or weakness on one side of the body. You may also feel numbness, dizziness, or vision changes. These symptoms can also be signs of a stroke, so you should seek medical help immediately.
  • Ophthalmic migraine: They are also known as ocular or retinal migraines. They cause short-term, partial, or total loss of vision in one eye, along with a dull pain behind the eye, which can spread to the rest of the head. Seek medical help immediately if you have any vision changes.
  • Migraine with brainstem aura: Dizziness, confusion, or loss of balance can occur before the headache. Pain can affect the back of the head. These symptoms usually start suddenly and may be accompanied by trouble speaking, ringing in the ears, and vomiting. This type of migraine is fully relevant to hormonal changes and mainly attacks young adult women. Again, have a doctor check for these symptoms right away.
  • Migraine state: This basic type of migraine can last more than 72 hours. The pain and nausea are so bad that you may need to go to the hospital. Sometimes medications or drug withdrawal can cause them.
  • Ophthalmoplegic migraine: This causes pain around the eye, including paralysis of the muscles around it. This is a medical emergency because symptoms can also be caused by pressure on the nerves behind the eye or by an aneurysm. Other symptoms include droopy eyelids, double vision, or other vision changes.

Causes of migraine

Researchers have not identified a definitive cause of migraines. However, they have found some funding factors that can trigger the situation. This includes changes in brain chemicals, such as a reduction in stages of the brain chemical serotonin.

Other factors that can trigger a migraine include:

  • Bright lights
  • Severe heat or other extremes in weather
  • Dehydration
  • Changes in barometric pressure
  • Hormonal changes in women, such as fluctuations in estrogen and progesterone during menstruation, pregnancy, or menopause
  • Excess stress
  • Loud sounds
  • Intense physical activity
  • Skip meals
  • Changes in sleep patterns
  • Use of some medications, such as oral contraceptives or nitroglycerin
  • Unusual smells
  • Certain foods
  • Smoking
  • Alcohol consumption
  • Travel

If you experience a migraine, your doctor may ask you to keep a headache diary. Inscription down what you were doing, the foods you ate, and the medications you were taking before your migraine started can help you recognize your triggers. Find out what else could be causing or triggering your migraines.

Risk factors for migraine

Risk factors may include:

Sex: Women have three times more migraines than men.

Years: Most people start having migraines between the ages of 10 and 40. But many women find that their migraines improve or go away after age 50.

Family history: Four out of five people with migraines have other family members who have them. If one of the parents has a history of these types of headaches, their child has a 50% chance of suffering from them. If both parents have them, the risk increases to 75%.

Other medical conditions: Depression, anxiety, bipolar disorder, sleep disorders, and epilepsy can increase your chances.

Symptoms of migraine

Symptoms of migraine include:

  •  The pain normally on one side of the head, but often on both sides
  •  Throbbing or throbbing pain
  •  Sensitivity to light, sound, and sometimes smell and touch
  •  Nausea and vomiting

Diagnosis of migraine

Your physician will ask about your medical history and indications. It can help to keep a journal of your symptoms and any triggers you have noticed. Make a note of:

  • What symptoms you have, including where it hurts
  • How often do you have them?
  • How long they last?
  • Any other family member who has migraines
  • All the medicines and supplements you take, even those over the counter
  • Other medications you remember taking in the past

Your physician may order checks to rule out other things that could cause your symptoms, including:

  • Blood test
  • Imaging tests such as MRIs or CT scans
  • Electroencephalogram (EEG)

Treatment for migraine

There is no cure for migraines. But many medications can treat or even prevent them. Common treatments for migraine include:

  • Pain relief. Over-the-counter (OTC) medications often work well. The main ingredients are acetaminophen (Panadol, Tylenol), aspirin (Bayer, Bufferin), caffeine, and ibuprofen (Advil, Motrin, Nuprin). Never give aspirin to anyone younger than 19 years old due to the risk of Reye’s syndrome. Be careful when taking over-the-counter pain relievers, because they can also make a headache worse. If you use them too much, you can get rebound headaches or become independent of them. If you take over-the-counter pain relievers more than 2 days a week, talk with your doctor about prescription drugs that might work best. They may suggest prescription medications that may work well to end migraine pain, including triptans as well as newer titans and pants. Your doctor can tell you if these are right for you.
  • Nausea medicine. Your doctor may prescribe medication if you have nausea with a migraine.
  • Triptans. These drugs balance the chemicals in your brain. You may be given a pill to swallow, lozenges to dissolve on the tongue, a nasal spray, or an injection. Samples include almotriptan (Axert), eletriptan (Relpax), sumatriptan (Imitrex), rizatriptan (Maxalt), and zolmitriptan (Zomig).
  • Ergotamine (Cafergot, Migergot, Ergomar), which also acts on chemicals in the brain
  • Lasmiditan (Reyvow). This medicine relieves pain, nausea, and sensitivity to light or sound.
  • CGRP receptor antagonists. Your doctor might prescribe rhyme.

Home remedies

You can ease migraine symptoms by:

  • Rest with your eyes closed in a dark, quiet room.
  • Put a cold pack or ice pack on your forehead
  • Drink a lot of liquids

Complementary and alternative treatments in migraine

Some people get relief from therapies they use in addition to or in place of traditional medical treatment. These are called complementary or alternative treatments. For migraine, they include:

  • Biofeedback. This way helps you take note of stressful situations that could trigger symptoms. If the headache starts slowly, biofeedback can stop the attack before it fully develops.
  • Cognitive-behavioral therapy (CBT). A specialist can teach you how your actions and thoughts affect the way you feel pain.
  • Supplements. Research has established that some vitamins, minerals, and herbs can prevent or treat migraines. These include riboflavin, coenzyme Q10, and melatonin. Butterbur can prevent migraines, but it can also affect liver enzymes.
  • Bodywork. Physical treatments such as chiropractic, massage, acupressure, acupuncture, and craniosacral therapy can relieve headache symptoms.

Talk to your doctor before trying complementary or alternative treatments.

Prevention

Try these steps to prevent symptoms:

  • Identify and avoid triggers. Keep track of your symptom patterns in a journal so you can find out what is causing them.
  • Manage stress. Relaxation techniques like meditation, yoga, and mindful breathing can help.
  • Eat on a regular schedule
  • Drink lots of fluids
  • Get plenty of rest
  • Get regular moderate exercise

Ask your doctor about preventative medications if you have migraines around your period or if lifestyle changes don’t help.

Complications

The International headache society created a system for classifying headaches and migraines and their complications, known as ICHD-3. Some of these include:

Migraine state

This rare and severe migraine with aura lasts more than 72 hours. Some people have been hospitalized due to severe pain.

Migraine infarction

This is when a migraine is associated with a stroke. Usually, this is a migraine with an aura that lasts for more than an hour. Sometimes the aura is present even when the headache goes away. An aura that lasts for more than an hour can be a sign of bleeding in the brain. If you have a migraine with an aura that lasts above an hour, see your physician right away.

Persistent aura without a heart attack

This complication arises if the aura lasts more than a week after the migraine has ended. This complication has symptoms similar to those of a migraine infarct, but there is no bleeding in the brain. See your doctor immediately for a proper diagnosis.

Migralepsy

This is a condition in which a headache triggers an epileptic seizure. Typically, the seizure will occur one hour after a migraine. This condition is rare.

Departments to consult for this condition

  • Department of Neurology
Categories
Disease

Types and Symptoms of Brain Tumors | Neurology

What are brain tumors?

Brain tumors are a collection or mass of abnormal cells in your brain. Your skull is very firm around your brain. Any growth within such a small space can cause problems. These can be cancerous (malignant) or non-cancerous (benign). When benign or malignant tumors grow, they can cause increased pressure inside your skull. It damages the brain and can be life-threatening.

Brain tumors are classified as primary or secondary. A primary brain tumor starts in your brain. Most primary brain tumors are benign. A secondary tumor, also known as a metastatic brain tumor, occurs when cancer cells spread to the brain from another organ, such as the lungs or breast.

Types of brain tumors

Primary brain tumors

Primary brain tumors start in your brain. They develop from you:

  • Brain cells
  • The layers that surround your brain are called meninges.
  • Nerve cells
  • Glands

Primary tumors can be benign or cancerous. In adults, the most common types of brain tumors are meningiomas.

Gliomas

Gliomas are tumors that develop from glial cells. These cells are usually:

  • Supports the structure of your central nervous system
  • Provide nutrition to your central nervous system
  • Clean cellular debris
  • Break dead neurons

Gliomas develop from a variety of glial cells.

Types of tumors that start in glial cells:

  • Astrocytic tumors, such as astrocytomas, that start in the brain.
  • Oligodendroglial tumors often found in the frontal-temporal lobes
  • Glioblastomas, which originate in the connective tissue of the brain and are very aggressive.

Other primary brain tumors

Other primary brain tumors:

  • Pituitary tumors, which are usually benign
  • Ependymomas, which are usually benign
  • Craniopharyngiomas, which are more common in children and are benign, but have clinical features such as vision changes and premature puberty.
  • Primary microbial cell tumors of the brain, which can be benign or malignant
  • Meningiomas, which originate in the meninges.
  • Schwannomas, which start in cells that make the protective covering of your nerve (myelin sheath) called Schwan cells.

Most meningiomas and schistosomiasis occur in people between the ages of 40 and 70. These are more common in women than in men. Schwannoma occurs equally in men and women. These tumors are usually benign, but they can cause problems due to their size and location. Cancerous meningiomas and schwannomas are very rare but very aggressive.

Secondary brain tumors

Secondary brain tumors are the majority of brain cancers. They start in one part of the body and spread to the brain or metastasize. The following can metastasize to the brain:

  • Lung cancer
  • Breast cancer
  • Kidney cancer
  • Skin cancer

Secondary brain tumors are always malignant. Benign types of tumors do not spread from one part of your body to another.

What are the risk factors for brain tumors?

Family history

Only 5 to 10 percent of all cancers are genetically inherited or hereditary. It is very rare for a brain tumor to be inherited genetically. If most of the people in your family are diagnosed with a brain tumor, talk to your doctor. Your doctor can recommend a genetic counselor

Years

The risk of many types of brain tumors increases with age.

Career

Brain tumors are more common in Caucasians. However, African-Americans are more likely to develop meningiomas.

Exposure to chemicals

Exposure to certain chemicals found in the workplace can increase the risk of brain cancer. The National Institute for Occupational Safety and Health maintains a list of carcinogenic chemicals found in the workplace.

Exposure to radiation

People exposed to ionizing radiation have a higher risk of developing brain tumors. You can be exposed to ionizing radiation through high-radiation cancer treatments. You will also be exposed to radiation from a nuclear fall. The events at the Fukushima and Chernobyl nuclear power plants are examples of how people are exposed to ionizing radiation.

Chickenpox has no history

People with a history of childhood chickenpox have a lower risk of developing brain tumors.

What are the symptoms of a brain tumors?

Some tumors cause direct damage by attacking brain tissue, and some tumors put pressure on the surrounding brain. You will notice noticeable symptoms when the growing tumor puts pressure on brain tissue.

Headache is a common symptom. You may experience headaches:

  • It happens when you are asleep
  • May be made worse by coughing, sneezing, or exercising

You can also experience:

  • Vomiting
  • Blurred vision or double vision
  • Confusion
  • Seizures (especially in adults)
  • The weakness of an organ or face
  • Change in mental functioning

Other common features:

  • Clumsy
  • Memory loss
  • Confusion
  • Difficult to write or read
  • Small changes in the ability to hear, taste, or smell
  • Decreased alertness, which can cause drowsiness and loss of consciousness
  • Hard to swallow
  • Dizziness or vertigo
  • Like eye problems, eyelids, and uneven pupils.
  • Uncontrolled movements
  • Shaking of the hand
  • Loss of balance
  • Loss of bladder or bowel control
  • Numbness on one side of the body
  • Difficulty speaking or understanding what others are saying.
  • Changes in mood, personality, emotions, and behavior.
  • Difficulty to walk
  • Muscle weakness in the face, arm, or leg

How are brain tumors diagnosed?

Diagnosis of a brain tumor begins with a physical exam and an examination of your medical history.

The physical exam involves a very detailed neurological exam. Your doctor will perform an exam to see if your cranial nerves are intact. These are the nerves that originate in your brain.

Your doctor will look inside your eyes with an ophthalmoscope, which will shine light through your pupils and onto your retinas. This allows your doctor to check how your students respond to light. This allows your doctor to look you directly in the eye to see if there is any inflammation of the optic nerve. As the pressure inside the skull increases, changes in the optic nerve can occur.

The doctor can also evaluate it:

  • Muscular strength
  • Coordination
  • Memory
  • Ability to do mathematical calculations.

Your doctor may order more tests after the physical exam is complete. These may include:

Computed tomography of the head

CT scans are ways to get a more detailed scan of your body than your doctor can do with an X-ray machine. The reverse can be done with or without.

Contrast is achieved in a CT scan of the head using a special dye, which helps the doctor see certain structures such as blood vessels more clearly.

Magnetic resonance of the head

If you have an MRI of the head, you can use a special dye to help your doctor identify tumors. MRI is different from a CT scan because it does not use radiation and generally provides more detailed images of structures in the brain.

Angiography

An angiography test uses a color that is inserted into your artery, usually in the groin area. The color goes to the arteries in your brain. This allows your doctor to see how the blood supply to the tumor is. This information can be helpful during surgery.

Skull X-rays

Brain tumors can cause fractures or fractures of the skull bones and can show specific x-rays if this occurs. These X-rays can also detect calcium deposits, which are sometimes present in the tumor. There may be calcium deposits in your bloodstream if your cancer has developed in your bones.

Biopsy

A small portion of the tumor is obtained during the biopsy. It is examined by a specialist called a neuropathologist. A biopsy will determine if the tumor cells are benign or malignant. It also determines if cancer started in your brain or in another part of your body.

Treatment for brain tumors

Brain tumor treatment depends on:

  • Tumor type
  • Tumor size
  • The location of the tumor
  • Your general health

The most common treatment for malignant tumors is surgery. The goal is to eliminate as much cancer as possible without harming healthy parts of the brain. The location of some tumors allows for easy and safe removal, while other tumors may be in an area that limits the distance the tumor can be removed. Partial elimination of brain cancer is also beneficial.

Risks of brain surgery include infection and bleeding. Clinically malignant tumors can also be removed surgically. Metastatic brain tumors are treated according to the guidelines for the actual cancer type.

Surgery can be combined with other therapies such as radiation therapy and chemotherapy.

Physical therapy, occupational therapy, and speech therapy can help you recover after neurosurgery.

Categories
Disease

Treatment and Diagnosis of Deep Vein Thrombosis | Cardiology

What is deep vein thrombosis?

Pulmonary embolism (PE) usually occurs when a blood clot, called deep vein thrombosis (DVT), often travels to your lungs and lungs in your leg and blocks a blood vessel. This can cause low oxygen levels in your blood. It can damage the lungs and other organs and even cause heart failure.

Pulmonary embolism can be fatal, so if you have deep vein thrombosis, you should be aware of this risk. Follow your deep vein thrombosis treatment plan to prevent clots from enlarging and to prevent new clots.

Symptoms of deep vein thrombosis

Some blood clots in the veins of the legs do not cause any symptoms. However, when blood clots form in large veins, they usually cause:

  • Swelling
  • A sensation of heaviness in the leg, particularly when you’ve been standing
  • Leg pain and tenderness

You can check for edema by pressing your finger on your leg. If you have edema, pressure from your finger will create a small gash in your leg for several seconds. Pulmonary embolism does not cause any symptoms, mild symptoms, or severe symptoms indicating a life-threatening emergency. Symptoms become more severe when the blood clot is large.

Symptoms of large clots include sudden shortness of breath and chest pain. Pain is like a knife. This can be very serious if you breathe deeply. If the pulmonary embolism is very large, the symptoms can be more dramatic. They can include epileptic seizures, severe shortness of breath, and coughing up blood. Large pulmonary embolism can cause sudden death.

Causes of deep vein thrombosis

Deep vein thrombosis blood clots usually prevent your blood from circulating or clotting, that is, venous damage, surgery, certain medications, and limited movement.

Risk factors for deep vein thrombosis

Almost anyone can have a deep vein thrombosis. However, certain factors can increase the chance of having this condition. The chance increases even more for someone who has more than one of these factors at the same time.

  • Injury to a vein
  • Slow blood flow
  • Increased estrogen
  • Certain chronic medical illnesses
  • Other factors that increase the risk
  • Injury or surgery. Venous or surgical damage increases the risk of blood clots.
  • Inheriting a blood clotting disorder. Some people inherit their disorder, which makes it easier for the blood to clot. This condition does not cause the blood to clot unless it is combined with one or more risk factors.
  • Heart failure. This increases your risk for deep vein thrombosis and pulmonary embolism. Because heart and lung function is limited in people with heart failure, symptoms of a small pulmonary embolism are also more common.
  • The pregnancy. Pregnancy increases the pressure on the veins in the pelvis and legs. Women with the inherited bleeding disorder are at special risk. The risk of blood clots from the uterus lasts up to six weeks after giving birth to your baby.
  • Sitting for long periods of time while driving or flying. When your legs are on for hours, the muscles in your calves do not contract, which generally promotes blood circulation. If your calf muscles do not move for a long time, blood will clot in your calves.
  • Of smoking. Smoking affects blood clotting and circulation, increasing the risk of deep vein thrombosis.
  • Some types of cancer increase the number of substances in your blood that can cause your blood to clot. Certain types of cancer treatment also increase the risk of blood clots.

Diagnosis

If a person suspects they have DVT, they should seek medical help immediately. Before performing the physical exam, the doctor will ask you questions about your symptoms and medical history.

  • Venogram: If ultrasound and D-dimer tests do not provide enough information, the doctor may order a scan. The doctor will stain the vein in the foot, knee, or groin. X-ray images can follow the color as it moves to reveal the location of the blood clot.
  • D-dimer test: Blood clotting Fibrinolysis D-dimer is the protein component of blood after clotting. A test result that reveals more than a specific result for a D-dimer indicates a blood clot. However, with some inflammatory conditions and after surgery, this test may not be reliable.
  • Other imaging scans: MRI and computed tomography show the presence of clots. These scans can detect blood clots when tested for other health problems.
  • Ultrasound: This type of scan can detect clots in the veins, changes in blood flow, and whether the clot is severe or chronic.

Treatment

Depending on your symptoms, your doctor may prescribe a medicine called a thrombolytic to dissolve the clot. These drugs can save your life, but they can also cause bleeding. You must be in the hospital and the staff will take care of you.

For some very serious cases, a specialist may need to perform surgery. If your symptoms are not life-threatening, or the thrombolytic use is too dangerous, your doctor may prescribe medicine that will stop the clotting process or prevent the platelets in your blood from sticking together. They don’t break down clots, but they don’t get bigger when your body melts.

Prevention

Once you get deep vein thrombosis or pulmonary embolism, the goal is to shrink and prevent further clots. Take the anticoagulant prescribed by your doctor and go through all subsequent appointments to make sure you do not develop this condition again.

  • Avoid sitting for a long time. When you have to travel by plane or car, get up and walk every hour with the blood flowing through your legs.
  • Try to exercise more. Being active can prevent blood clots from forming.
  • Wear compression stockings. These put gentle pressure on the legs to prevent swelling and keep the blood from clotting. They help prevent both deep vein thrombosis and PTS.
  • Keep your legs horizontal while seated to help your blood flow faster.
Categories
Disease

Overview of Marfan Syndrome and Aorta Disease | Cardiology

What is marfan syndrome?

Marfan syndrome is a relatively common genetic disorder of connective tissue that affects many organ systems, but the most serious complications are aortic aneurysms and dissection. A variety of medical and surgical approaches are available to manage cardiovascular complications. Our aim was to compare elective graft surgery, elective valve-sparing surgery, and medical management of patients with Marfan syndrome and thoracic aorta disease on the basis of life expectancy with different aortic root diameters and rate of increase in aortic root size.

People with Marfan syndrome are usually tall and slender with disproportionately long arms, legs, fingers, and toes. The damage from Marfan syndrome can be mild or severe. If the aorta – the large blood vessel that carries blood from your heart to the rest of your body – is affected, the condition may become life-threatening.

Treatment usually includes medications to keep blood pressure low to reduce pressure on the aorta. Regular monitoring to check damage progression is vital. Many people with Marfan syndrome eventually need preventive surgery to repair the aorta.

Marfan syndrome symptoms

Marfan syndrome is an inherited “altered expression” disorder. This means that signs and symptoms can vary from person to person. They can also vary in their severity, and they can range from mild to life-threatening. Symptoms tend to get worse with age.

People with Marfan syndrome may have:

  • A tall, thin build
  • A chest that sinks in or sticks out
  • Crowded teeth
  • Flat feet
  • Disproportionately long arms, legs, fingers, toes, along with flexible joints
  • The curvature of the spine(scoliosis)
  • Heart murmurs
  • Stretch marks

What causes marfan syndrome?

Marfan syndrome is rare, occurring in about 1 in 5,000 people. The Marfan disorder is brought about by a transformation in a quality called FBN. As far as possible the body’s capacity to make the proteins expected to construct connective tissue. One out of four individuals with Marfan disorder will build up the condition for obscure reasons.

How is marfan syndrome diagnosed?

Marfan syndrome signs and symptoms vary from patient to patient. Here is a portion of the tests your primary care physician may perform:

  • A physical examination and family history.
  • With a stethoscope, the doctor will listen to your heart for any abnormal heart sounds.
  • Echocardiography can be used to find valve function, movement of the heart wall and total heart volume.
  • A computed tomography (CT or CAT) scan reveals cross-sectional images of the body, particularly the aorta.
  • Magnetic resonance imaging (MRI) gives doctors a detailed image of the heart and aorta.

Treatment of marfan syndrome

There is no medical treatment to reverse the fibrillin abnormalities in people with Marfan syndrome. In the future, research on a strain of mice that bred with similar problems with fibrillin may lead to the successful treatment of Marfan.

Until then, doctors try to prevent or delay the changes in the aorta that appear in Marfan patients by prescribing drugs that reduce the pressure inside the aorta. Your doctor may advise you to take a beta-blocker and/or an angiotensin receptor blocker called losartan (Cozaar). Beta-blockers, such as propranolol (Inderal), metoprolol (Lopressor), atenolol (Tenormin) and reduce pressure on the aorta wall by slowing the heart rate and reducing the strength of heart contractions, especially during exercise. Losartan and other angiotensin receptor blockers help lower blood pressure, which reduces pressure on artery walls.

If you have Marfan, your doctor will monitor your heart health with periodic echocardiograms to check for problems with the aorta and mitral valve. In the event that a major issue is discovered, you may require a medical procedure to supplant the aortic valve, mitral valve, or part of the aorta. Doctors are concerned when the size of the aortic root measured on an echocardiogram enlarges over time. Once it reaches 5 cm or more, many experts recommend surgery. Some recommend smaller aortic root enlargement surgery.

You should follow a non-strenuous exercise program that includes non-competitive, non-contact sports (walking, cycling, and jogging), which you can do at your own pace.

If you have Marfan-related scoliosis with a temperature between 20 and 40 degrees, you can be treated with a brace and physical therapy. For scoliosis greater than 45 degrees, you will need surgery. You should have an annual eye exam to look for Marfan-related eye problems. If you suffer from ectopia, you may be able to be treated with special lenses called lenses and special eye drops to dilate the pupil instead of surgery. If eye surgery is necessary, it should be performed in an ophthalmology center that specializes in treating Marfan syndrome.

Complications of marfan Syndrome

Marfan syndrome causes a variety of health complications. Many of these factors affect the valves of the heart and blood vessels, which is why we created our comprehensive care center.

Serious complications

The most serious complications may include the heart valves or the aorta, which is the main artery that supplies blood to your body. As a result, Marfan can lead to:

  • Aortic aneurysm: When part of the aorta wall stretches and weakens, it is called an aortic aneurysm.
  • Aortic dissection: Dilated and weakened aorta may rupture and leak blood. This serious condition, called an aortic dissection, causes intense pain in the front or back of the chest or abdomen.
  • Aortic regurgitation: The aortic valve stretches and allows blood to leak back into the left ventricle, a type of aortic valve disease. Ultimately, this condition can cause cardiomyopathy (enlarged and weakened heart muscles) or congestive heart failure.
  • Mitral valve disease: Marfan syndrome can cause two types of mitral valve disease. Mitral valve prolapse results when the valve between the upper and lower chambers on the left side of the heart does not close properly. As the condition progresses, it can cause mitral valve regurgitation, resulting in a heart murmur or heart palpitations, shortness of breath, and fatigue.

Other complications of marfan syndrome

Marfan syndrome can also cause these other complications.

These may include eye complications:

  • Detached retina
  • Early glaucoma or cataracts
  • Dislocated lens
  • Severe nearsightedness

Symptoms that affect other parts of the body may include:

  • Dilation of the cyst around the spinal cord, which leads to pain, numbness, or weakness in the legs
  • The tiny air sacs dilate in the lungs, which can lead to lung collapse

Risk factors

Marfan syndrome affects both men and women and occurs among all races and ethnic groups. Because it is an inherited condition, the biggest risk factor for Marfan syndrome is that a parent has the disorder.

Marfan syndrome prevention

For the prevention of complications, as well as improving the quality of life of patients diagnosed with MFS, careful monitoring and pharmacological and/or surgical intervention when indicated is critical.

  • Monitoring and precautions

Cardiac abnormalities are common in patients with MFS and therefore, annual or more frequent echocardiograms are recommended to prevent fatal complications. Avoiding contact sports and activities that cause fatigue is extremely important for MFs because of the underlying weakness of the blood vessels and problems of the aorta. Additionally, it is important to use SBE (subacute bacterial endocarditis) with antibiotics during dental work in order to prevent bacterial infection of the heart valves or the structures inside the heart. Due to the fact that the symptoms of MF and other genetic disorders often overlap, genetic testing is valuable to confirm the diagnosis and facilitate the development of correct preventive measures and treatments.

  • Pharmacologic therapy

Prescription medications such as beta-blockers or angiotensin receptor blockers that have the ability to reduce hemodynamic pressure on the aortic wall and slow the growth of the aortic root can improve the overall survival of those diagnosed. It also lowers blood pressure, reduces susceptibility to distention at the level of the ascending aorta, and reduces the rate of aortic complications. This treatment has been shown to be most beneficial when the diagnosis and appropriate treatment are started early.

Categories
Disease

Treatment and Symptoms of Brain Aneurysm | Neurology

What is a brain aneurysm?

A brain or intracranial aneurysm is an abnormal focal dilation of an artery in the brain that results from the weakening of the inner muscular layer (the intima) of the wall of a blood vessel. The vessel develops a “blister-like” dilation that can thin and rupture without warning. The resulting bleeding into the space around the brain is called a subarachnoid hemorrhage (SAH). This type of bleeding can lead to stroke, coma, and/or death.

Aneurysms are typically established at the base of the brain, just inside the brain, in an area called the subarachnoid space. 90 percent of SAH are attributed to ruptured brain aneurysms, and the two terms are often used synonymously.

Aneurysms range in size from small (about 1/8 inch) to almost an inch. Aneurysms larger than one inch are called giant aneurysms, they are particularly high risk and difficult to treat. The exact mechanisms by which brain aneurysms develop, grow, and fracture is unknown.

Symptoms of a brain aneurysm

Ruptured aneurysm

Sudden, severe pain is the key sign of a ruptured aneurysm. This headache is regularly defined as the “worst headache” ever experienced.

Corporate signs and symptoms of a ruptured aneurysm include:

  • Sudden and extremely severe headache
  • Nausea and vomiting
  • Stiff neck
  • Blurred or double vision
  • Sensitivity to light
  • Convulsion
  • A droopy eyelid
  • Loss of consciousness
  • Confusion

‘Leaky’ aneurysm

In some cases, an aneurysm can lose a small amount of blood. This leak (sentinel bleeding) can cause only:

  • Sudden and extremely severe headache
  • A more severe rupture often follows a leak

Unruptured aneurysm

An unruptured brain aneurysm may not cause symptoms, especially if it is small. However, a larger unruptured aneurysm can press on the tissues and nerves of the brain, possibly causing:

  • Pain above and behind one eye
  • Dilated pupil
  • Change in vision or double vision
  • Numbness on one side of the face

Causes of a brain aneurysm

Any condition that causes the walls of the arteries to weaken can lead to one. The most common culprits are atherosclerosis and high blood pressure. Deep wounds and infections can also lead to an aneurysm. Or you can be born with a weakness in one of your artery walls.

Risk factors for brain aneurysm

Several factors can contribute to the weakness of an artery wall and increase the risk of a brain aneurysm or aneurysm rupture. Brain aneurysms are more common in adults than children and more common in women than men.

Some of these risk factors change over time others are present-day at birth.

Risk factors that develop over time. These include:

  • Advanced age
  • Smoking cigarettes
  • High blood pressure (hypertension)
  • Drug abuse, particularly cocaine use
  • Excessive alcohol consumption

Some types of aneurysms can occur after a head injury (dissecting aneurysm) or certain blood infections (fungal aneurysm).

Risk factors present at birth

Selected conditions dating from birth may be associated with an elevated risk of developing a brain aneurysm. These include:

  • Hereditary connective tissue disorders, such as Ehlers-Danlos syndrome, which weaken blood vessels.
  • Polycystic kidney disease, an inherited disorder that produces fluid-filled sacs in the kidneys and usually increases blood pressure.
  • Abnormally narrow aorta (coarctation of the aorta), the large blood vessel that carries oxygen-rich blood from the heart to the body.
  • Cerebral arteriovenous malformation (cerebral AVM), an abnormal connection between arteries and veins in the brain that interrupts the normal flow of blood between them.
  • Family past of brain aneurysm, particularly a first-degree relative, such as a parent, brother, sister, or child.

Diagnosis of a brain aneurysm

If you experience a sudden, severe headache or other symptoms possibly related to a ruptured aneurysm, you will undergo a test or series of tests to determine if you have bled into the space between the brain and surrounding tissues (subarachnoid hemorrhage). or possibly another type of stroke.

If bleeding has occurred, your emergency care team will determine if the cause is a ruptured aneurysm.

If you show symptoms of an unruptured brain aneurysm, such as pain behind the eye, vision changes, or double vision, you will also have some tests to identify the causative aneurysm.

Diagnostic tests include:

Computed tomography (CT): A CT scan, an expert X-ray exam, is usually the first test used to determine if you have bleeding in the brain. The test produces images that are two-dimensional “parts” of the brain.

With this test, you may also undergo an injection of a dye that makes it easier to see blood flow in the brain and can indicate the presence of an aneurysm. This difference in the test is called CT angiography.

Cerebrospinal fluid test: If you’ve had a subarachnoid hemorrhage, there are most likely red blood cells in the fluid that surrounds your brain and spine (cerebrospinal fluid). Your doctor will order a cerebrospinal fluid test if you have symptoms of a ruptured aneurysm, but a CT scan has shown no evidence of bleeding.

The procedure to remove cerebrospinal fluid from the back with a needle is called a lumbar puncture (lumbar puncture).

Magnetic resonance imaging (MRI): An MRI uses a magnetic field and radio waves to create detailed images of the brain, either in 2-D slices or 3-D images.

A type of MRI that evaluates the arteries in detail (magnetic resonance angiography) can detect the presence of an aneurysm.

Cerebral angiogram: During this procedure, also called a cerebral arteriogram, your doctor inserts a thin, flexible tube (catheter) into a large artery, usually in the groin, and passes it through the heart into the arteries in the brain. A special dye that is injected into the catheter travels to arteries throughout the brain.

A series of X-ray images can reveal details about the conditions of your arteries and detect an aneurysm. This test is more invasive than others and is generally used when other diagnostic tests do not provide enough information.

Treatment for brain aneurysm

Surgery

There are two common treatment choices for a ruptured brain aneurysm.

  • Surgical trimming is a procedure to close an aneurysm. The neurosurgeon gets rid of a section of your skull to access the aneurysm and finds the blood vessel that foods the aneurysm. Then, he places a small metal clip on the neck of the aneurysm to stop the flow of blood.
  • Endovascular coiling is a less invasive procedure than the surgical clip. The surgeon inserts a hollow plastic tube (catheter) into an artery, usually in the groin, and passes it through your body to the aneurysm.

Next, he uses a guide wire to push a soft platinum wire to complete the catheter and into the aneurysm. The wire coils inside the aneurysm interrupt blood flow and essentially seals the aneurysm from the artery.

Both of these procedures present potential risks, particularly bleeding in the brain or loss of blood flow to the brain. Endovascular coiling is less invasive and may be safer initially, but may have a slightly higher risk of needing a repeat procedure in the future due to the reopening of the aneurysm.

Flow diverters

Newer treatments available for brain aneurysm include flow diverters, tubular stent-shaped implants that work by diverting blood flow away from the aneurysm sac. Bypassing stops the movement of blood within the aneurysm and thus stimulates the body to heal the site, which encourages reconstruction of the mother artery. Flow diverters can be above all useful in larger aneurysms that cannot be safely treated with other options.

Your neurosurgeon or interventional neuroradiologist, in collaboration with your neurologist, will make a commendation based on the size, location, and general appearance of the brain aneurysm, your ability to undergo a procedure, and other factors.

Other treatments (ruptured aneurysms)

Other treatments for ruptured brain aneurysms aim to relieve symptoms and control complications.

  • Pain relievers, such as acetaminophen (Tylenol, others), can be used to treat headaches.
  • Calcium channel blockers prevent calcium from entering the cells of the blood vessel walls. These medications can decrease the erratic narrowing of the blood vessels (vasospasm) that can be a complication of a ruptured aneurysm.

One of these drugs, nimodipine has been shown to decrease the risk of late brain damage caused by insufficient blood flow after subarachnoid hemorrhage from a ruptured aneurysm.

  • Interventions to prevent a stroke due to insufficient blood flow include intravenous injections of a drug called a vasopressor, which raises blood pressure to overawed the resistance of narrowed blood vessels. An alternative intervention to prevent a stroke is angioplasty. In this procedure, a surgeon uses a catheter to inflate a small balloon that expands a narrow blood vessel in the brain. A medicine known as a vasodilator can also be used to expand the blood vessels in the affected area.
  • Anti-seizure medications can be used to treat seizures related to a broken aneurysm. These medicines include levetiracetam phenytoin (Dilantin, Phenytek, others), valproic acid (Depakene), and others. Its use has been debated by various experts and is generally subject to the discretion of the caregiver, depending on the medical needs of each patient.
  • Ventricular or lumbar drainage catheters and bypass surgery can lower pressure on the brain from excess cerebrospinal fluid (hydrocephalus) associated with a ruptured aneurysm. A catheter may be placed into the fluid-filled spaces within the brain (ventricles) or around your brain and spinal cord to drain excess fluid into an external bag. Sometimes it may be necessary to insert a shunt system, which consists of a flexible silicone rubber tube (shunt) and a valve, which creates a drainage channel that begins in your brain and ends in your abdominal cavity.
  • Rehabilitation therapy: Damage to the brain from a subarachnoid hemorrhage can result in the need for physical, speech, and occupational therapy to relearn skills.

Complications

When a brain aneurysm ruptures, the bleeding usually lasts for only a few seconds. Blood can cause direct damage to surrounding cells, and bleeding can damage or destroy other cells. It also increases the pressure inside the skull.

If the pressure becomes too high, the supply of blood and oxygen to the brain can be cut off to the point of loss of consciousness or even death.

Complications that can develop after an aneurysm ruptures include:

  • New bleeding. An aneurysm that has ruptured or leaks is at risk of bleeding again. Re bleeding can cause more damage to brain cells.
  • Vasospasm. After a brain aneurysm ruptures, the blood vessels in the brain can narrow erratically (vasospasm). This situation can limit blood flow to brain cells (ischemic stroke) and cause added cell damage and loss.
  • Hydrocephalus. When a ruptured aneurysm causes bleeding into the space between the brain and surrounding tissue (subarachnoid hemorrhage), more often, the blood can block the circulation of the fluid that surrounds the brain and spinal cord (cerebrospinal fluid). This condition can result in excess cerebrospinal fluid that increases pressure on the brain and can damage tissues (hydrocephalus).
  • Hyponatremia. Subarachnoid hemorrhage from a ruptured brain aneurysm can upset the sodium balance in the blood. This can occur from damage to the hypothalamus, an area near the base of the brain.

A decrease in sodium levels in the blood (hyponatremias) can lead to inflammation of brain cells and permanent damage.

Prevention

If you have an enraptured brain aneurysm, you can reduce your risk of rupturing by making these lifestyle changes:

  • Don’t smoke or use recreational drugs. If you smoke or use recreational drugs, talk with your doctor about strategies or an appropriate treatment program to help you quit smoking.
  • Eat a healthy diet and exercise. Changes in diet and exercise can help lower blood pressure. Talk to your doctor about the changes that are right for you.

Departments to consult for this condition

  • Department of Neurology