(I) Case
Richard was sitting in his chair watching Television when part of the screen appeared to go dark. He started to push himself out of the chair, but found his left arm was very weak, and he went nowhere. He tried to call his wife, but could not find the words. After fifteen minutes, the TV screen gradually filled in, strength returned to his arm, and he was able to tell his wife what he had experienced. Richard’s doctor did some tests, then referred him to a vascular surgeon, who ordered a duplex Doppler exam, which showed a narrowing in the carotid artery in the fight side of the neck. He underwent uneventful surgery to eliminate the problem.
Q: What seems to be your problem?
A: 1. My headaches are recently becoming more frequent and more severe.
2. I have throbbing pain on one side of my head.
3. My neck and shoulder muscles are tender.
4. I feel tingling in my face and arms.
5. I have trouble concentrating.
6. I have a pressing sensation above my eyes.
7. One side of my head is numb.
Q: Do you have nausea, vomiting, or any other symptom else?
A: 1. I have nausea, and I am experiencing flashing lights and blurred vision.
2. I had a blackout.
3. The left side of my body is paralyzed.
4. My cheek became swollen and painful.
(III) TIA: Transient Ischemic Attack
A transient ischemic attack is a temporary event, usually disappear within 10 to 20 minutes. If you have experienced one, you run a major risk of stroke, unless you undergo treatment. If you have had one TIA, your chances are about fifty-fifty of developing a stroke before having another TIA. A very large study of 595 patients who had experienced a TIA, loss of vision in one eye, or a non-disabling stroke in the presence of a 70 to 99 percent carotid artery blockage.
The most common surgical approach to prevent stroke is carotid endarterectomy. The surgical procedure removes carotid atherosclerotic plaque and debris, which is usually well localized to the easily accessible area in your neck where the common carotid artery divides.
(IV) Stroke
Strokes occur in two different ways: Ischemic strokes are caused by blood clots that block the supply of blood to areas of the brain. They account for 70 to 80 percent of all strokes. Hemorrhagic strokes, the more deadly of the two, are caused by blood vessels that rupture in the brain itself or on the surface of the brain.
(V) Warning Signs of A Stroke
Call 911 or other emergency services immediately if you think you may be having a stroke. Do not try to drive yourself to the hospital. If medical treatment is sought as soon as stroke symptoms are noticed, fewer brain cells may be permanently damaged by the stroke.
Seek immediate medical help if you or someone you know experiences:
l Sudden, temporary weakness of the face, hand, arm or leg on one side of the body.
l Temporary difficulty speaking or loss of speech altogether, or trouble understanding someone speaking.
l Double vision or sudden, temporary dimness of vision or loss of vision, particularly in one eye.
l Temporary dizziness, unsteadiness, or sudden falls.
(VI) The Road Back from a Stroke
1. Through rehabilitation, the brain can develop new pathway that circumvent damaged connections and switches.
2. Some cells are dead, some that were just outside the damaged area aren’t dead but are not functioning. In the three months after a stroke, these cells will start to recover. As recovery progresses, these still-living cells may take over some of the functions the dead cells used to perform. They’ll need practice.
3. Spend time with other survivors and their families. They can inspire you and ignite your will to get on with life. Hospital social workers, senior centers, stroke survivors’ organizations are all sources of support group information.
(VII) Vocabularies
Migraine
Dementia
Facial Spasm
Meningitis
Tension Headache / Stress Headache
Hemiplegia / One-sided Paralysis
Parplegia / Lower Body Paralysis
Quadriplegia / Whole Body Paralysis
Facial Palsy
Motion Sickness
Neuralgia
Concussion
Coma
Slurred Speech
Blurred Vision
(VIII) Dialogues
P: He complained of continued violent headache and failing vision. I also saw him vomiting this morning.
N: His vomiting comes from the anemia of the vital centers in the medulla oblongata and his blurred vision is caused by congestion of the optic nerves. We need to X-ray his head to see if there is an intracranial tumor of the brain.
P: Intracranial tumor?
N: Yes. Tumors of this kind tend to interfere with vision. If left untreated, he might become blind.
P: Will he need an operation on his brain to remove the tumor? Is such an operation dangerous?
N: The operation itself isn’t dangerous. To treat the tumor, however, is not an easy task.
P: The patient over there seems to have no consciousness. Does he suffer from a tumor, too?
N: No. He is a boxer, knocked out in the ring. He has been unconscious for six days. His delay in recovery is due to edema, an excessive accumulation of serous fluid in the brain. We have used hypertonic salines to treat his edema.
P: And how about the third patient there?
N: He suffers from a gun-shot wound. His dura mater is torn. We need to operate immediately to excise the wound in the scalp and bone and suck out spicules and diffluent brain matter. We’ll use celluloid plates to close the defects in the bone and sterilize and heal the wound.
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