12/22/2014

骨質疏鬆骨折的影響



骨質疏鬆容易引致骨折,約兩成股骨骨折個案會在一年內去世、三至五成患者會喪失自我照顧能力。其次是脊椎骨骨折,會引發持續背痛,或坐或站都有困難,更可能出現駝背,胸口痛和雙腳麻痹等情況。

確診骨質疏鬆症病人,一線治療是透過藥物及補充鈣質,但單靠用藥對骨折癒合幫助有限,以脊椎骨折為例,近半數患者痛楚會持續一年,甚至出現新的脊椎骨折!




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,
應向自己的神經外科醫生查詢,而不應單倚賴以上提供的資料。

12/18/2014

天氣急凍血壓急升特別多中風 - 寒冷天多中風, 中風先兆



天氣忽冷忽熱,有腦科專家警告,氣溫由暖急劇轉冷,慢性病患者難以適應,血壓容易飆高,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痹,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。

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,是中風高危期,「天氣由暖變凍,血壓會突飆高,特別多中風爆血管個案。」



頸痛危險徵兆
頸痛也是中風徵狀,該院腦神經內科專科醫生梁浩雲指一名四十歲男教師月前突頸痛,及後左邊身麻痹及口齒不清,入院檢查揭右腦缺血性中風,右側頸動脈血塊阻 塞,持續半年服抗凝血藥及做物理治療。左腳雖已活動正常可走路,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,梁建議中年人士應定期做心腦血管及頸動脈檢查。此外,該院心髒中心總監李少隆指,心 房顫動病人有百分之七至一成機會並發中風。

五十歲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。

藍明權 神經外科醫生






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。

12/17/2014

顎骨矯形致中風罕見

顎 骨矯形手術後出現腦中風,腦科醫生及牙科醫生均指,情況較為罕見。神經外科專科醫生藍明權表示,若腦中風因頸動脈撕裂引起,涉及的應為內頸動脈,該主動脈 由頸部經牙骨後面直上腦部,負責供血給腦部,由於下顎牙骹骨較接近該動脈,若手術期間拉扯到均可能傷及頸動脈。不過,口腔頜面外科醫生則認為,病人在術後 第六日才出現中風,認為由她本身身體問題引起機會較大。




 

大力按頸可撕裂動脈

藍明權表示,下顎牙骹骨接近內頸動脈,若在牙科手術中,曾將牙骹骨切割,或將牙骹骨「拉上拉落」,均有拉扯及傷到頸動脈風險,會形成血塊,衝上腦部出現中 風。他指大力按摩頸部、交通意外「chok親」或部份頸椎手術,均有機會出現頸動脈撕裂,引致腦中風。
不願具名的資深口腔頜面外科專牙醫則指,顎骨矯形手術為常見處理「倒及牙」的方法,一般風險為傷口腫痛、流血、傷及牙床神經線等,但較少機會出現中風。

他表示,做「倒及牙」顎骨矯形手術,會將下顎如威化餅般中間切開,形成兩層牙骨再移動合適位置固定,下顎骨後會有不同血管,但直接弄傷頸脈動機會極低。


藍明權 神經外科醫生






參考資料:  http://hk.apple.nextmedia.com/
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。

12/09/2014

Why do I need surgery ? (2)




Preparing for surgery
You may be told to see your general practitioner before surgery to check your overall health. Tell your doctor what medications you are taking, and ask if you should stop taking any medications before surgery. 
 
o make your recovery easier, prepare your home for life after surgery. Place important things within easy reach. Remove safety hazards that might cause you to lose your balance. Arrange for someone to help you at home and around the house after surgery. You will most likely be told not to eat or drink the night before the surgery. Be sure you read and understand this entire booklet. Your surgeon is required to let you know of the potential risks, as well as benefits, of this surgery.



After surgery
Ask your surgeon about your specific recovery plan following surgery. It is important to follow your doctor’s instructions carefully to recover from surgery as quickly as possible and increase your chances of a successful outcome.
 
After surgery your surgeon may refer you to physical therapist who will teach you exercises to improve your strength and increase your mobility. The goal of physical therapy is to help you become active as soon as possible, using safe body movements that protect your neck.
Recovering from pain and surgery is an ongoing process. How fast you recover depends on your commitment to working closely with your physical therapist, and moving and exercising correctly, as recommended by your surgeon.
 
 
 
 
 
 
Reference: www.brain-spine.com.hk/
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your orthopedic doctors for diagnosis and treatment.

12/08/2014

Why do I need surgery ? (1)




As discs lose their water content because of disease or age, they lose their height and bring the vertebrae closer together. The consequence is a weakening of the shock absorption properties of the disc and a narrowing of the openings for the nerves in the sides of the spine. Additionally, a loss of disc height may cause the formation of bone spurs, which can push against your spinal cord and/or nerves.

When a disc ruptures in the cervical spine, it puts pressure on one or more nerve roots (called nerve root compression) or on the spinal cord, causing pain and other symptoms in the neck and arms. Living with this pain or weakness and tingling in the arms can be disabling.


Disc degeneration
With the advice of your doctor, you may have tried other treatments for some time now which did not relieve your pain or dysfunction. Or perhaps your doctor has determined that irreparable damage would result without surgery. Your doctor has recommended that you consider the PRESTIGE® LP Cervical Disc Prosthesis, which provides for motion following surgery, instead of the more common fusion procedure.


What is involved in a PRESTIGE® LP Cervical Disc System procedure?
This surgery involves the use of a new medical device, which is designed to replace the disc which sits between the vertebrae in your neck. Your disc, which is damaged or diseased, is surgically removed through an incision made in the front of the neck.

In its place, your surgeon will prepare a space and insert a PRESTIGE® LP Cervical Disc Prosthesis. The device utilizes a ball and socket design which is designed to allow for motion to be preserved.




Reference: www.brain-spine.com.hk/

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your orthopedic doctors for diagnosis and treatment.

12/03/2014

抗憂鬱症藥物使用原則




憂鬱症是可以治療的,然而,多數憂鬱症患者對於漫長的療程太早喪失信心,以致於藥物治療時間不足,無法達到令人滿意的效果。一般而言,要經過約四個星期的時間,患者才會發現負面情緒明顯好轉;要讓藥物治療完全解除憂鬱症則需要更久的時間。  




藥物的使用原則
1.      選擇副作用較少,病人可以忍受的藥物;無法哪一種藥物,,療效差異不大。
2.      除非有特殊原因,否則應儘量使用單一種的抗憂鬱劑。
3.      盡量使用每日服用一次的藥物,增加病人服藥遵從性與慣性。
4.      可優先使用病人或家屬服用過且有效的抗憂鬱劑。
5.      對於激躁不安的憂鬱症患者,TCAtrazodone有鎮靜作用;反應遲滯的憂鬱症患者,可以使用較具活力的藥物,如fluoxetineMAOI
6.      憂鬱症患者若有精神病症狀,可以合併低劑量的抗精神病藥物。




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。

12/02/2014

12歲童作嘔暈倒須鑽腦放水

一名12歲熱愛運動的男童,昨凌晨於太古城家中,突感頭部劇痛及作嘔不適,未幾更不支暈倒,其父母立即將他送院搶救;醫生估計男童小腦出血,立即替他進行腦部手術,男童移送深切治療部留醫仍未渡過危險期,命懸一線。




父﹕身體健康 甚少看醫生

懷 疑腦出血男童林俊希,與父母及兄長同住太古城春櫻閣。林童剛畢業於中國婦女會丘佐榮小學,成績名列前茅,曾在繪畫比賽中得獎,作品更是以奧運馬術為題,下 月升上心儀的英文中學。林父稱,俊希喜歡運動,身體健康,甚少看醫生,為南華會泳隊隊員,暑假常帶他遠足及游水。由於兒子無外遊及跌倒紀錄,家人不知為何 會得大病。


昨日凌晨5時 許,俊希於睡夢中突感頭部痛楚及作嘔,同房兄長發現拍門通知父母,父母陪林童到廁所嘔吐,未幾林童已暈倒地上毫無反應,其父立即報警將俊希送院。醫生搶救 後,懷疑俊希小腦出血,立即施手術在其腦部鑽洞口放水,以減低腦壓,林童留醫深切治療部。其父母擔心不已,一直留守醫院照料。

腦外科專科醫生藍明權表示,若出現突發性頭痛及嘔吐徵狀,懷疑是出血及急性膜炎兩個原因。出血屬原發性,病者或有先天性血管畸形,血管較薄,一旦膨脹便容易破裂,可於12分鐘內出血,病者平日健康正常,並無任何象。急性腦膜炎則是病菌入腦所致,病者會出現頭痛及嘔吐徵狀,病徵持續時間約數小時。


藍明權指出,病者於腦出血時,腦部會脹起,令頭顱骨壓力增加,醫生會施藥或在內鑽洞放水,以減低腦壓,情嚴重才會使用鑽洞方式。


腦外科專科醫生藍明權提醒家長,若發現子女經常頭痛、頭脹及疲累,可能屬初步現象,應到醫院檢查。







參考資料: www.mingpaohealth.com  
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。