出血性中風

 “中風“一般可分為兩大類：腦內血管栓塞及腦內血管破裂出血（俗稱“爆血管“），而腦出血中風是比較嚴重的一種，可引致病者殘廢以及死亡
成因
1。高血壓
2。動脈血管瘤（瘤）
一）可由動脈硬化，感染，創傷及先天性因素而形成
3。腦動靜脈畸形（動靜脈畸形，動靜脈畸形）
4。由藥物引致，例如薄血藥及阿士匹靈等
病徵
1。突然性的頭痛
2。噁心及嘔吐
3。中樞神經系統受損的徵狀如肢體癱瘓，麻痺，視野模糊，言語障礙及神經紊亂等
4。昏迷
治療方法
1。必須緊急入院治療
2。用藥物停止出血
3。可能以手術除去大血塊
4。手術清除血管瘤及腦動靜脈畸形
什麼情況要看醫生

1。頭痛發作情況急而劇烈
2。與平常頸痛的病徵有異，例如頻頻發作，在搖頭，低頭，咳嗽或躺下時會增加痛楚
3。頭部受傷复感頭痛及昏睡
4。頭痛以外，身體並他方面出現問題，如：

一）噁心，嘔吐
二）頸項及背部僵硬
三）中樞神經系統出現問題如視覺蒙糊，肢體麻痺及神經紊亂等

參考資料: www.brain-spine.com.hk, http://www.neuropainhk.org/

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。

腦膜炎和創傷性撞擊

腦膜受到感染而發炎

發病年齡

1.      主要是幼兒或小童，或其他易受感染之成年人，如有免疫系統疾病等

病徵

1.      頭痛

2.      頸痛或頸僵硬

3.      發燒

4.      眼睛對光線敏感

5.      皮膚出紅疹、斑點

6.      神智不清

治療

1.      需立刻入院治理

2.      診斷

a)      病狀如頸僵硬等

b)      抽脊液檢查

c)      電腦素描

3.      藥物

a)      需接受靜脈注射高劑量抗生素

創傷性撞擊 Head Injury

腦部受創而產生傷害，如車禍、意外或受襲擊等

危險病徵

1.      失去知覺5分鐘以上

2.      頭暈、噁心甚至嘔吐、出現重影

3.      手腳乏力、說話困難

4.      抽筋等中樞神經系統受損的徵狀

可能情況

1.      腦內出血

腦創傷後症候群如長期頭痛、頭暈等

參考資料: www.brain-spine.com.hk, http://www.neuropainhk.org/

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。

甚麼是中風？

中風如何發生？

當通往腦部的血流受阻，令到受影響區域的腦細胞死亡，就會發生中風。中風可分為兩大類：

• 缺血性中風：約85%的中風個案皆屬缺血性中風，其成因是血凝塊阻塞通往腦部的血管。
• 出血性中風：這是由通往腦部的血管爆裂所致。

甚麼是暫時缺血性中風(小中風)？

提供應腦部的血液暫時減少，就會出現暫時缺血性中風，俗稱小中風。小中風的症狀與中風相似，不同之處是小中風的症狀一般於24小時內消失，而且不會導致永久性的損害。然而，小中風已是一個嚴重警號，表示腦部缺血，中風可能即將發生。

事實上,,有多達半數的中風個案患者事前都曾經中風或有出現小中風。

缺血性中風的根本成因，是由一種名為動脈粥樣硬化栓塞的疾病導致腦血管阻塞所引起。

參考資料: http://www.neuropainhk.org/ , 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。

偏頭痛 Migraine

主要是因腦血管擴張而刺激到神經所引發的頭痛，大部份病患者也有同類的家族病史
病徵
1.偏左或偏右

2.痛楚的感覺有如脈搏跳動

3.有部份病者在頭痛前可出現先兆如看見閃光、視野中有黑點、口唇、手部麻痺等4.感到噁心、出汗及面色蒼白

5.畏光
引發偏頭痛的原因
1.壓力、過激烈情緒

2.過多或缺少睡眠

3.天氣變化

4.濃烈氣味(例如：吸煙)

5.內分泌變化(例如：懷孕期，服用口服避孕藥物，月經週期變化等)

6.食物(例如：濃味芝士，酒精，巧克力，味精，代糖，經發酵制食品等)

7.強光，閃光
治療方法
1. 避免可誘發偏頭痛的原因
2. 兩種藥物
a. 發作時服用特效止偏頭痛藥
b. 定時服用預防偏頭痛藥，例如特效消炎止痛藥，鬆弛血管藥或抗癲癇藥

參考資料: http://www.surgery.cuhk.edu.hk/neuro/default.htm , 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。

頸椎椎間盤病變

一般為退化性疾病。由於年齡增長，頸椎椎間盤會逐漸失去所含水分，繼而失去吸收震動能力。當椎間在頸椎區域破裂時會對一條或多條神經以至脊髓產生壓力，引起頭部或手臂的疼痛。在本港，約三至四成超過四十歲人士患有頭椎椎間盤病變，而且人數隨年齡增加。患者一般感到頸部或手部痛楚，肢體乏力，行動困難，甚至出現失禁情況。如不及早治理，頸椎神經會因長時間受壓，而大大減低康復機會。

脊椎的結構

u        脊柱由三十三節脊骨組成，包括七節頸椎、十二節胸椎、五節腰椎、五節融合的薦椎及四節已融合的尾骨，用作支撐人體及保護脊髓。

u        上部的七節頸椎骨由纖維軟骨(椎間盤)分隔，可有助吸收活動時所產生的震盪，容許身體作出種種動作。

u        脊骨中空位置是脊髓神經，經椎間孔穿出椎管後，形成大大小小的神經分支，並分佈於頸背、胸腹及四肢，使身體產生感覺及進行各種活動。

甚麼是椎間盤病變

椎間盤病變可是由創傷、長期勞損或退化而致。當患者的椎間盤「核質」膨脹或「外環」破裂時便令神經受壓，進而使頸部及手部產生痛楚。突出的椎間盤甚至會引發不同形狀的骨質，即骨刺，在其周圍產生，增加對神經所產生的壓力，可能會進一步加劇痛楚。若已接受非創傷性的治療後，如藥物或物理治療，仍未能有效地控制病情，則可考慮手術治療。

參考資料: www.back.com, 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。

失眠

何謂失眠？

醫學上對失眠的定義是：難以入睡、持續睡眠、隔天清晨醒來汲有睡飽的感覺。失眠是一種症狀而非疾病，必需先找出潛在的病因加以治療，而不是只有治療失眠的症狀而已。

美國國家健康組織﹝National Institute of Health﹞ 把失眠症依病程時間分為短暫性失眠﹝短於一星期﹞、短期性失眠﹝1-3星期﹞及長期性失眠﹝超過3星期﹞。

1.      短暫性失眠：

遇到重大壓力﹝如考試或競賽﹞、情緒上的激動﹝如興奮或憤怒﹞等都可能會失眠。而跨越時區旅行造成的時差反應也會對睡眠有所影響。

 

2.      短期性失眠：

病因和短暫性失眠有些雷同，但時間較長。有人在喪偶、離婚、生命中出現重大變數時，會造成情緒上的衝擊，平復所需要的時間可能長達數星期。

3.      長期性失眠：

這類失眠患者必須到失眠門診求診才行，病史有些達數年或數十年之久，必須找出潛在病因才有治療的希望。

參考資料: http://zh.wikipedia.org
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。

Easing Back Pain Once It Starts

If you are experiencing pregnancy-related back pain, consult with your doctor and follow his or her suggestions as to what's right for you. In addition to the above preventive measures, commonly prescribed therapies for easing pregnancy-related back pain can include:

·         Hot or cold therapy, in the form of a warm bath, a hot water bottle, or an ice pack.

·         Physical therapy specifically designed to address the needs of your changing body as your pregnancy progresses.

·         Anti-inflammatory/analgesic medications, as recommended by your doctor. Acetaminophen has been shown to be safe for pregnant women; others, including aspirin and ibuprofen, are not.

·         Complementary treatments such as chiropractic care, massage therapy, and acupuncture. Although these therapies have not been proven effective for treating low back pain, they may provide some relief for pregnancy-related discomfort, and perhaps some stress relief as well. Consult with your doctor first, however, to ensure there is no underlying spinal condition causing the pain.

Reference: www.back.com, brain-spine.com.hk

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

Easing Back Pain Once It Starts

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

If you are experiencing pregnancy-related back pain, consult with your doctor and follow his or her suggestions as to what's right for you. In addition to the above preventive measures, commonly prescribed therapies for easing pregnancy-related back pain can include:

·         Hot or cold therapy, in the form of a warm bath, a hot water bottle, or an ice pack.

·         Physical therapy specifically designed to address the needs of your changing body as your pregnancy progresses.

·         Anti-inflammatory/analgesic medications, as recommended by your doctor. Acetaminophen has been shown to be safe for pregnant women; others, including aspirin and ibuprofen, are not.

·         Complementary treatments such as chiropractic care, massage therapy, and acupuncture. Although these therapies have not been proven effective for treating low back pain, they may provide some relief for pregnancy-related discomfort, and perhaps some stress relief as well. Consult with your doctor first, however, to ensure there is no underlying spinal condition causing the pain.

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

How Can I Prevent Back Pain During My Pregnancy?

To optimize your chances of keeping back pain at bay, there are a variety of preventive measures you can take:

·         First, maintain a reasonable activity level and — under your doctor's supervision — incorporate exercises that gently stretch and strengthen your back and abdominal muscles. "Keep moving!" advises Dr. Peters. "The ability and motivation to remain active is very important during this time."

·         If you spend your days behind a desk, take advantage of opportunities to get up and stretch your legs — and back — while getting your work done.

·         Maintaining good posture as your body changes is also important. As your center of gravity shifts forward, minimize the strain on your lower back by standing as straight as possible, keeping your shoulders back and your buttocks tucked under. When sitting, keep your feet slightly elevated, if possible. Choose a chair that supports your back — use a small pillow if necessary — and change positions frequently.

·         Be mindful of body mechanics. If you need to pick something up, don't bend over and lift using your back. Instead, squat using your knees, keeping your back straight as you lift. Avoid positions that require bending or twisting. Listen to your body — if something hurts, don't do it!

·         Don't be a slave to fashion. If you're hooked on high-heeled shoes, kick the addiction — at least for a few months. Cute "sensible shoes" do exist — just look for low heels and good arch support. Your clothing can also be back-friendly — look for maternity pants with a low, supportive waistband. Later in your pregnancy, you may want to use a support belt under your lower abdomen.

·         It may seem like the impossible dream at this point in your life, but do try to get a sufficient amount of sleep. Practice relaxation techniques, and keep stress to a minimum. Sleep on your side rather than your back, keeping your knees bent. Place pillows around your abdomen for support, if needed.

Reference: www.back.com., www.ispine.com.hk

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

Why Does My Back Hurt?

There are a number of reasons you can develop back pain during pregnancy. "It's a multifactorial issue," Dr. Peters says. "Hormonal alterations in soft tissue and even bone tissue play a part, along with changes in weight, spinal alignment, and activity level."

The hormones that are released during pregnancy allow joints and ligaments in the pelvic area to become more pliant and loose, in preparation for the birthing process, Dr. Peters explains. The downside of this softening is that it can affect the natural support your back normally receives, particularly as the weight of your baby increases.

A growing baby also causes your center of gravity to shift. Abdominal muscles stretch and weaken, making it more difficult to maintain good posture and further challenging your natural spinal alignment. "In the third trimester, for example, the forward flexion of the hips brings the pelvis and sacrum forward as well, contributing to a 'swayback' effect in the lumbar spine," Dr. Peters says. "Increasing breast tissue can also accentuate this shift in spinal realignment. Some of these tissue and mechanical alignment alterations are good for the body, in order to distribute weight gain to the middle of the body where, structurally, it's the strongest. But in a woman whose structure is weak where stress is magnified, low back pain can be the result."

Common patterns of pregnancy-related back pain include pain in the lower back, or lumbar spine, and pain that feels like it's centered even lower in the body, in the back, or posterior, of the pelvic area. If pressure is placed on the sciatic nerve or presses on a spinal disc, pain may extend through the hips, buttocks and legs.

Reference: www.back.com.

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