孩童與青少年期常見的憂郁症症狀

如果家中青少年在短期內出現功課突然退步、突然坐立不安、身體動作突然變慢、講話音調變單調、沉默不語、不明原因的情緒激躁、無法解釋地哭泣、常顯得害怕或緊張、突然變得有攻擊性、出現反社會行為、使用酒精或成癮性物質、抱怨身體某部位疼痛不適卻又找不到病因等，可能是罹患憂郁症的前兆。

嚴重憂郁症患者可能伴隨的症狀：妄想與幻聽等症狀，常常容易使醫生誤診為精神分裂症。

不可不知的憂郁症問題

∎ 50%的憂郁症發病年齡在20-50歲。

∎ 老年憂郁症的盛行率為25-50%。

∎ 婦女罹患憂郁症的可能性是男性的兩倍。

∎ 任何年齡的人都可能患上憂郁症，但在育齡婦女中最為常見。

∎ 憂郁症與許多生理疾病有關。

∎ 患者有心胸病、中風、癌症及糖尿病的患者罹患憂郁症的比率更高。

∎ 自殺死亡的個案中，約90會在生前患有憂郁症，反之，憂郁症患者約15%最後會選擇自殺。

參考資料: www.brain-spine.com.hk

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向神經外科醫生查詢，而不應單倚賴以上提供的資料。

Hydrodiscetomy: Cutting with Water

Hydrodiscetomy is solving unmet needs and improving outcomes in spine surgery by providing fluidjet-driven medical devices for use in ‘open’ and ‘minimally invasive’ spine procedures.

The products empower neurosurgeons to simultaneously cut, ablate, and remove hard and soft tissue quickly, safely, and effectively— without the collateral thermal or mechanical trauma of other surgical modalities. Imagine being able to remove tissue during back surgery via an opening the size of a straw—with the aid of a hair-thin, 600-miles-per-hour stream of water, instead of a one- to two-inch incision from an ‘open’ surgery with a scalpel. Although high-pressure water jets have been employed for many years in industrial cutting applications, this technology is not easily adapted for use in medicine because of the unique technical requirements of surgery:

(1) the working fluid must be sterile;
(2) the tools must be tiny and easily maneuverable;
(3) the pump system must be small enough to fit in any operating room; and,
(4) the devices must be safe.

Hydrodiscetomy has overcome the major barriers to the transfer of fluidjet technology from industrial to surgical applications with significant technical innovations. As a result, a growing number of neurosurgeons are using Hydrodiscetomy to wash away patients’ pain in a variety of back procedures. Unique to Hydrodiscetomy’s devices is the use of a ‘collector’ tube, not only to capture the fluidjet stream, but also to create a powerful ‘Venturi’- and-morcellation effect at the active site—resulting in tissue being drawn into the collector tube and thus away from the operative site, without the need for an external suction connection. This also allows optimal visibility during operation of the device—particularly important in spine procedures, where the surgical site is surrounded by vital structures such as nerves and blood vessels.

A further major advantage of Hydrodiscetomy is the ability to achieve ‘selective’ tissue excision. The tissue selectivity benefit allows spine surgeons to quickly and safely remove appropriate tissue, such as disc nucleus, without damaging the surrounding harder tissue or vertebral endplates. These advantages illustrate the power and versatility of Hydrodiscetomy to provide solutions to the spine surgeon, enabling efficient surgical procedures and optimal patient outcomes.

Reference: http://www.minimally-invasive-centrehk.com

The above information serves as educational reference only, you should consult your neurosurgeon for diagnosis, treatments and surgeries.

坐骨神經痛 (Sciatica)

坐骨神經是人體最長的神經線，從下腰一直延伸到腳掌。假如這束神經任何一處受損或受壓，都可引起坐骨神經痛。

嚴格來說，坐骨神經痛是一種症狀，最常見的病因是椎間盤脫位，壓住神經線所致。

坐骨神經痛相當普遍，很多時只影響身體的一邊，疼痛從臀部開始蔓延至大腿後面及小腿，並帶有麻痺感，如果情況嚴重，更會使下肢肌肉無力，影響病人行動。急性椎間盤脫位可引致小便失禁，必須立即施行手術。

坐骨神經痛發作時，下半身就好像有一條橡筋被硬拉到腿部般，而當要坐下、咳嗽、打噴嚏、用力甚至笑的時候，痛楚還會加劇。

參考資料: www.brainspine.com.hk

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的醫生查詢，而不應單倚賴以上提供的資料。

中風高危期

近來天氣忽冷忽熱，有神經科專家警告，氣溫由暖急劇轉冷，慢性病患者難以適應，血壓容易颯高，每年十一月及一至二月，均是中風高峰期。中風除了半身乏力及口齒不清等典型徵狀外，頸痛及視力短暫模糊亦是危險徵兆。曾有四十歲男教師突然頸痛及半身麻痺，入院檢驗方知頸動脈及腦血管栓塞，至今中風一個多月，仍未回復左手功能，需緊密康復治療才有望重拾教鞭。

中年應定期檢查心腦血管

仁安醫院神經外科專科醫生藍明權指，全港每年有二萬六千多人中風，每年十一月天氣轉冷，及一至二月氣溫驟降，均是中風高危期，「天氣由暖變凍，血壓會突然颯高，特別多中風爆血管個案。」

頸痛也是中風徵狀，一名四十歲男教師月前突然頸痛，及後左邊身麻痺及口齒不清，入院檢查發現右腦缺血性中風，右側頸動脈有血塊阻塞，要持續半年服抗凝血藥及做物理治療。左腳雖已活動正常，可以走路，但左手活動能力較差，無力拿水杯，也暫不能打字，預料有一半機會完全康復。患者沒有定期身體檢查，中風後才發現有高血壓、高膽固醇及糖尿病，這均是中風高危因素，建議中年人士應定期做心腦血管及頸動脈檢查。

此外，心房顫動病人有百分之七至一成機會併發中風。五十歲的陳先生健康一直良好，但近半年持續心跳不規則，至出現右邊身乏力才求診，入院後檢驗方發現左腦輕微血管栓塞。原來他病發前三個月其視力已短暫模糊，突然眼前一黑，一分鐘才回復正常。

參考資料: orientaldaily.on.cc

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的醫生查詢，而不應單倚賴以上提供的資料。

頭痛 (Headache)

頭痛─是一般人尋醫診治的常見症狀之一，但對於輕微的頭痛，很多人也會嘗試自行處理，例如：

1. 稍作休息、熱水浴及睡眠等，以作鬆弛神經

2. 多喝水或喝不含酒精的飲料

3. 服用無須醫生處方的止痛藥，例如(paracetamol \ acetaminophan及阿士匹寧,

頭痛的成因很多，常見的包括：緊張性頭痛、眼部疲勞或因長期費神集中工作、發燒、感冒、偏頭痛、醉酒、鼻竇炎，亦有些嚴重而有威脅生命的頭痛成因，例如：腦中風(出血性中風)、腦瘤、腦膜炎、創傷性撞擊

緊張性頭痛 Tension Headache

這類頭痛主要是由於過度疲勞或其他心理因素而引致頭、頸的肌肉收縮所形成的擠壓性痛症

病徵

頭部買週或局部的沉重或刺痛，頸部有時亦呈僵硬狀態。有些病者甚至會有其他精神緊張的病徵如心跳、氣促、失眠、精神不穩等

治療方法

1. 藥物治療

2. 物理治療及針炙治療

3. 矯正或改變生活方式，盡量減少壓力，多作休息，保持心境開朗

參考資料: www.brainspine.com.hk

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的醫生查詢，而不應單倚賴以上提供的資料。

Prevalence, Pathophysiology and Symptoms of Neuropathic Cancer PAIN – Hong Kong review

PAIN can be a persistent and incapacitating symptom of cancer. Although reports indicate only 15% of patients with nonmetastatic disease experience tumour-associated PAIN at the time of diagnosis, PAIN becomes more pervasive as disease progresses.1 In patients with recurrent or metastatic cancer, 67% complain of PAIN and 41% experience PAIN directly attributable to the disease. PAIN may be

chronic or acute, and patients with chronic PAIN commonly experience acute flares of PAIN.

One half to two thirds of patients with well-controlled chronic PAIN experience transitory ‘breakthrough’ PAIN. Cancer-associated PAIN may be secondary to antineoplastic therapy or an unrelated comorbid condition, but is commonly due to direct tumor involvement (ie, infiltration or compression of adjacent local structures, such as bone, soft tissue, nerves or the gastrointestinal tract).1,4 Hence, cancer PAIN syndromes can be somatic, visceral or neuropathic in origin.3 Understanding and recognizing these syndromes can help identify PAIN etiology and the need for additional evaluation, and target therapy more appropriately.

Reference source: http://www.neuropainhk.org, www.brainspione.com.hk

The above information is for educations only, if you have any related disease, please consult your neurosurgeon for more information.