Stroke

Stroke is sudden onset of neurological disability. It happens because of sudden blockage of blood vessel in the brain or sudden bleeding in the brain. Within minutes, the affect part of the brain dies. On average, every year, 26,000 new patients suffer from stroke in Hong Kong. The peak time for onset of stroke is when temperature suddenly drops, e.g. around November to December.

Symptoms of stroke

The symptoms of stroke include (1) weakness or numbness of the face, arm or leg, (2) confusion and drowsiness, (3) difficult to speak, (4) dizziness, (5) blurring of vision, (6) severe headache, (7) incontinenece, (8) vomiting, and (9) coma. Mini-stroke means patients suffered for one or more of the above named symptoms, but only temporarily. 

Risk factors

Stroke can be caused by diseases such as, diabetes mellitus, atrial fibrillations, high blood pressure, high blood cholesterol level. Patient with following diseases would have higher risk of stroke.

1. Patients with coronary artery disease, cardiac & peripheral vascular disorders
2. Cigarette smoker
3. Obesity
4. Lack of physical activity

Some patients have hidden time bomb in the brain, e.g. cerebral aneurysm or arteriovenous malformation, which may cause bleeding in the brain.

 Reference: http://www.brain-spine.com.hk/stroke.html

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon immediately.

Stroke

Stroke is sudden onset of neurological disability. It happens because of sudden blockage of blood vessel in the brain or sudden bleeding in the brain. Within minutes, the affect part of the brain dies. On average, every year, 26,000 new patients suffer from stroke in Hong Kong. The peak time for onset of stroke is when temperature suddenly drops, e.g. around November to December.

Symptoms of stroke

The symptoms of stroke include (1) weakness or numbness of the face, arm or leg, (2) confusion and drowsiness, (3) difficult to speak, (4) dizziness, (5) blurring of vision, (6) severe headache, (7) incontinenece, (8) vomiting, and (9) coma. Mini-stroke means patients suffered for one or more of the above named symptoms, but only temporarily. 

Risk factors

Stroke can be caused by diseases such as, diabetes mellitus, atrial fibrillations, high blood pressure, high blood cholesterol level. Patient with following diseases would have higher risk of stroke.

1. Patients with coronary artery disease, cardiac & peripheral vascular disorders
2. Cigarette smoker
3. Obesity
4. Lack of physical activity

Some patients have hidden time bomb in the brain, e.g. cerebral aneurysm or arteriovenous malformation, which may cause bleeding in the brain.

 Reference: http://www.brain-spine.com.hk/stroke.html

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon immediately.

Stroke

Stroke is sudden onset of neurological disability. It happens because of sudden blockage of blood vessel in the brain or sudden bleeding in the brain. Within minutes, the affect part of the brain dies. On average, every year, 26,000 new patients suffer from stroke in Hong Kong. The peak time for onset of stroke is when temperature suddenly drops, e.g. around November to December.

Symptoms of stroke

The symptoms of stroke include (1) weakness or numbness of the face, arm or leg, (2) confusion and drowsiness, (3) difficult to speak, (4) dizziness, (5) blurring of vision, (6) severe headache, (7) incontinenece, (8) vomiting, and (9) coma. Mini-stroke means patients suffered for one or more of the above named symptoms, but only temporarily. 

Risk factors

Stroke can be caused by diseases such as, diabetes mellitus, atrial fibrillations, high blood pressure, high blood cholesterol level. Patient with following diseases would have higher risk of stroke.

1. Patients with coronary artery disease, cardiac & peripheral vascular disorders
2. Cigarette smoker
3. Obesity
4. Lack of physical activity

Some patients have hidden time bomb in the brain, e.g. cerebral aneurysm or arteriovenous malformation, which may cause bleeding in the brain. 

 Reference: http://www.brain-spine.com.hk/stroke.html

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon immediately.

Stroke

Stroke is sudden onset of neurological disability. It happens because of sudden blockage of blood vessel in the brain or sudden bleeding in the brain. Within minutes, the affect part of the brain dies. On average, every year, 26,000 new patients suffer from stroke in Hong Kong. The peak time for onset of stroke is when temperature suddenly drops, e.g. around November to December.

Symptoms of stroke

The symptoms of stroke include (1) weakness or numbness of the face, arm or leg, (2) confusion and drowsiness, (3) difficult to speak, (4) dizziness, (5) blurring of vision, (6) severe headache, (7) incontinenece, (8) vomiting, and (9) coma. Mini-stroke means patients suffered for one or more of the above named symptoms, but only temporarily. 

Risk factors

Stroke can be caused by diseases such as, diabetes mellitus, atrial fibrillations, high blood pressure, high blood cholesterol level. Patient with following diseases would have higher risk of stroke.

1. Patients with coronary artery disease, cardiac & peripheral vascular disorders
2. Cigarette smoker
3. Obesity
4. Lack of physical activity

Some patients have hidden time bomb in the brain, e.g. cerebral aneurysm or arteriovenous malformation, which may cause bleeding in the brain. 

 Reference: http://www.brain-spine.com.hk/stroke.html

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon immediately.

Epidural Corticosteroid Injection: Drug Safety Communication - Risk of Rare But Serious Neurologic Problems

ISSUE: FDA is warning that injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death. The injections are given to treat neck and back pain, and radiating pain in the arms and legs. The effectiveness and safety of epidural administration of corticosteroids have not been established, and FDA has not approved corticosteroids for this use.

FDA is requiring the addition of a Warning to the drug labels of injectable corticosteroids to describe these risks.

BACKGROUND: To raise awareness of the risks of epidural corticosteroid injections in the medical community, FDA’s Safe Use Initiative convened a panel of experts, including pain management experts to help define the techniques for such injections which would reduce preventable harm. The expert panel’s recommendations will be released when they are finalized. FDA will convene an Advisory Committee meeting of external experts in late 2014 to discuss the benefits and risks of epidural corticosteroid injections and to determine if further FDA actions are needed.

RECOMMENDATION: Patients should discuss the benefits and risks of epidural corticosteroid injections with their health care professionals, along with the benefits and risks associated with other possible treatments.



Source:

http://www.fda.gov/safety/medwatch/safetyinformation/safetyalertsforhumanmedicalproducts/ucm394530.htm

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.

What is Stroke?

Stroke is sudden onset of neurological disability. It happens because of sudden blockage of blood vessel in the brain or sudden bleeding in the brain. Within minutes, the affect part of the brain dies. On average, every year, 26,000 new patients suffer from stroke in Hong Kong. The peak time for onset of stroke is when temperature suddenly drops, e.g. around November to December.

Symptoms of stroke

The symptoms of stroke include
(1) weakness or numbness of the face, arm or leg,
(2) confusion and drowsiness,
(3) difficult to speak,
(4) dizziness,
(5) blurring of vision,
(6) severe headache,
(7) incontinenece,
(8) vomiting,
(9) coma.

Mini-stroke means patients suffered for one or more of the above named symptoms, but only temporarily.




Reference: http://www.brain-spine.com.hk/index-english.html
The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon.

   

Symptoms of stroke

Stroke is sudden onset of neurological disability. It happens because of sudden blockage of blood vessel in the brain or sudden bleeding in the brain. Within minutes, the affect part of the brain dies. On average, every year, 26,000 new patients suffer from stroke in Hong Kong. The peak time for onset of stroke is when temperature suddenly drops, e.g. around November to December.

Symptoms of stroke

The symptoms of stroke include (1) weakness or numbness of the face, arm or leg, (2)  confusion and drowsiness, (3) difficult to speak, (4) dizziness, (5) blurring of vision, (6) severe headache, (7) incontinenece, (8) vomiting, and (9) coma. Mini-stroke means patients suffered for one or more of the above named symptoms, but only temporarily.

Risk factors

Stroke can be caused by diseases such as, diabetes mellitus, atrial fibrillations, high blood pressure, high blood cholesterol level.

Patient with following diseases would have higher risk of stroke.

1.          Patients with coronary artery disease, cardiac & peripheral vascular disorders

2.          Cigarette smoker

3.          Obesity

4.          Lack of physical activity

Some patients have hidden time bomb in the brain, e.g. cerebral aneurysm or arteriovenous malformation, which may cause bleeding in the brain.

Prevention

Primary prevention is more important than treatment after stroke. More than half of the strokes are preventable. Persons with regular physical activities, balance diet, not smoking have a much lower chance of stroke. Good control of blood pressure, blood glucose and lipid are very effective way of preventing stroke. Person with family history of stroke, should have detailed body check up to see if there are risk factors for stroke.

Treatment & Surgery

Stroke is an emergency.  If patients suffered from stroke attend hospital immediately and have accurate diagnosis of stroke within the golden hours of treatment, there are drugs that can stop further bleeding in the brain or unblock a blocked blood vessels.  In severe case, neurosurgical operation may be needed remove blood clot in the brain or blockage of bleeding vessels.  Nowadays, neurosurgeon can use cure cerebral aneurysm or arteriovenous malformation without open surgery.

After stroke, most patients need treatment of the cause of stroke with medications or neurosurgery. Surgical procedures includes (1) carotid endarterectomy or angioplasty to remove significant narrowing of the artery to the brain, (2) clipping of endovascular embolization of cerebral aneurysm. (3) Surgery or radiosurgery for arteriovenous malformation.

Many patients need to undergo a series of rehabilitation like physiotherapy, speech therapy, occupational therapy, etc…

Reference information: www.brain-spine.com.hk, http://www.back.com/

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 Neurosurgeon for diagnosis and treatment.

Stroke

Stroke is sudden onset of neurological disability. It happens because of sudden blockage of blood vessel in the brain or sudden bleeding in the brain. Within minutes, the affect part of the brain dies. On average, every year, 26,000 new patients suffer from stroke in Hong Kong. The peak time for onset of stroke is when temperature suddenly drops, e.g. around November to December.

Symptoms of stroke

The symptoms of stroke include (1) weakness or numbness of the face, arm or leg, (2)  confusion and drowsiness, (3) difficult to speak, (4) dizziness, (5) blurring of vision, (6) severe headache, (7) incontinenece, (8) vomiting, and (9) coma. Mini-stroke means patients suffered for one or more of the above named symptoms, but only temporarily.

Risk factors

Stroke can be caused by diseases such as, diabetes mellitus, atrial fibrillations, high blood pressure, high blood cholesterol level.

Patient with following diseases would have higher risk of stroke.

1.          Patients with coronary artery disease, cardiac & peripheral vascular disorders

2.          Cigarette smoker

3.          Obesity

4.          Lack of physical activity

Some patients have hidden time bomb in the brain, e.g. cerebral aneurysm or arteriovenous malformation, which may cause bleeding in the brain.

Prevention

Primary prevention is more important than treatment after stroke. More than half of the strokes are preventable. Persons with regular physical activities, balance diet, not smoking have a much lower chance of stroke. Good control of blood pressure, blood glucose and lipid are very effective way of preventing stroke. Person with family history of stroke, should have detailed body check up to see if there are risk factors for stroke.

Treatment & Surgery

Stroke is an emergency.  If patients suffered from stroke attend hospital immediately and have accurate diagnosis of stroke within the golden hours of treatment, there are drugs that can stop further bleeding in the brain or unblock a blocked blood vessels.  In severe case, neurosurgical operation may be needed remove blood clot in the brain or blockage of bleeding vessels.  Nowadays, neurosurgeon can use cure cerebral aneurysm or arteriovenous malformation without open surgery.

After stroke, most patients need treatment of the cause of stroke with medications or neurosurgery. Surgical procedures includes (1) carotid endarterectomy or angioplasty to remove significant narrowing of the artery to the brain, (2) clipping of endovascular embolization of cerebral aneurysm. (3) Surgery or radiosurgery for arteriovenous malformation.

Many patients need to undergo a series of rehabilitation like physiotherapy, speech therapy, occupational therapy, etc…

Reference information: www.brain-spine.com.hk, http://www.back.com/

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 Neurosurgeon for diagnosis and treatment.

Are there any screening tools to help diagnose neuropathic pain?

Various screening tools are available to help physicians diagnose neuropathic pain. The European Federation of Neurological Societies (EFNS) has recently published updated guidelines that provide an overview of, and recommendations on, the key screening tools. These tools are: the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS)2; Neuropathic Pain Questionnaire (NPQ)3; Douler Neuropathique en 4 questions (DN4)4; PainDETECT5; ID Pain6; and the standardized evaluation of pain (StEP)7. All these screening tools have been validated in various neuropathic pain populations; the LANSS, DN4 and StEP utilize interview questions and physical examination, while the NPQ, PainDETECT and ID Pain use only interview questions. Of relevance to the Hong Kong population, one of the screening tools – the ID Pain – has been translated to and validated. The validity of the 6-item patient-completed questionnaire was assessed in 92 patients with either neuropathic or nociceptive pain. At a score of 3 or more, the questionnaire correctly classified 71% of cases. While screening tools are useful for identifying patients with possible neuropathic pain, particularly by non-specialist physicians, they do have limitations. As noted in the EFNS guidelines, these tools fail to identify 10–20% of patients with physician-diagnosed neuropathic pain; hence, they should be used together with a thorough patient history and physical examination.

ID pain

1 Did the pain feel like pins and needles? 您的痛楚是否好像被針刺般疼痛？

2 Did the pain feel hot/burning? 您的痛楚是否灼熱或好像被火燒一樣？

3 Did the pain feel numb? 您的痛楚是否帶有麻痺？

4 Did the pain feel like electrical shocks? 您的痛楚是否好像觸電一樣？

5 Is the pain made worse with the touch of clothing or bedsheets? 您的痛楚是否因觸碰衣服或床單而加劇？

6 Is the pain limited to your joints? 您的痛楚是否只限於關節部位？

Reference: http://www.neuropainhk.org

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your doctor immediately.

What is neurosurgery? And what is the neurosurgeon do?

Neurosurgery is a specialty of surgery which provides the critical care, prevention, diagnosis, evaluation, treatment, and rehabilitation of neurological disorders. This includes the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify the function or activity of the nervous system, including the hypophysis and the operation and non-operative treatment of pain. As such, neurosurgery encompasses treatment of adult and pediatric patients with disorders of the nervous system: disorders of the brain, meninges, and the skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland, disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.

What is neurosurgeon?

Neurosurgeon is a surgical doctor specialized in neurological disorders.

Central Nervous System (CNS) disorders - Stroke, Parkinsonism disease, Dementia, Brain tumors, Acoustic neuroma, Arteriole-venous malformation (AVM), etc...

Peripheral Nervous System (PNS) disorders – like Back pain, Scoliosis, Sciatica, Low back pain, Neck pain, Neuropathic pain, etc…  .

Reference information: www.brain-spine.com.hk, http://www.surgery.cuhk.edu.hk/neuro/default.htm

The information above is used for educational purpose only, for any enquiries, please consult your neurosurgeon for medical advices.