#carotid arter

[k-i-l-l-e-r-b-e-e-6-9]

Illustration of the common carotid artery taken from A System of the Anatomy of the Human Body (c.1814) by Andrew Fyfe

[mcatmemoranda]

Going through questions:

Both polymyalgia rheumatica (PMR) and giant cell arteritis (also known as temporal arteritis) are chronic inflammatory diseases. PMR is a common chronic inflammatory condition in adults >age 50, although prevalence varies among different countries and populations. Approximately 1 in 5 patients with PMR will have or develop giant cell arteritis, while approximately 50% of patients with giant cell arteritis have or have had PMR.

Giant cell arteritis can affect any medium or large artery, particularly the extracranial carotid branches. The temporal artery is often involved, and the ophthalmic artery may also be affected. This can result in neuro-ophthalmic complications, including permanent blindness. For this reason giant cell arteritis with ophthalmic symptoms is considered a medical emergency. Patients with PMR should be evaluated for symptoms of giant cell arteritis, such as visual changes, new-onset headaches, jaw claudication, or scalp tenderness. Giant cell arteritis is confirmed with a temporal artery biopsy, while PMR is diagnosed using a scoring system of signs and symptoms. The treatment of choice for both conditions is high-dose oral prednisone, tapered over months to years as symptoms abate.

Antineutrophil cytoplasmic antibody–associated vasculitis, polyarteritis nodosa, Takayasu arteritis, and granulomatosis with polyangiitis (formerly called Wegener’s granulomatosis) are not uniquely associated with PMR.

The goal fasting blood glucose level in patients with gestational diabetes is <95 mg/dL. A fasting glucose level <80 mg/dL is associated with increased maternal and fetal complications. The goal 2-hour postprandial glucose level is <120 mg/dL and the goal 1-hour postprandial glucose level is <140 mg/dL.

Chest radiographic findings in acute respiratory distress syndrome (ARDS) include bilateral airspace opacities but not a localized infiltrate as with pneumonia or a flattened diaphragm as with COPD. Clinically, ARDS will often present similarly to pneumonia or heart failure with dyspnea, hypoxemia, and tachypnea. However, ARDS typically does not respond to supplemental oxygen or diuretic therapy. Patients may decompensate quickly and require mechanical ventilation. The Berlin classification required mechanical ventilatory support in the definition of ARDS, but the COVID-19 pandemic has demonstrated that some patients with mild ARDS can be treated with noninvasive respiratory support.

[sanjeevannetralaya]

Central Retinal Artery Occlusion (CRAO) Ayurvedic Treatment

Central Retinal Artery Occlusion is a condition where blood flow to the retina is stopped. This is usually caused by a clot (or embolus) that travels to central retinal artery, and gets lodged in the vessel. The blockage cuts off blood flow to all of the retina.

Permanent vision loss can be prevented by prompt medical attention for CRAO. The vision loss in the affected eye is often permanent and will cause vision loss. CRAO is similar to BRAO in that it can be caused by trauma, atherosclerosis and hypercoagulable states. It is important that CRAO is less common than BRAO but has a worse prognosis.

What are the causes of Central Retinal Artery Occlusion

Central Retinal Artery Occlusion is caused by a blockage of the central retinal artery. This is the main blood vessel that supplies blood the retina. The causes of CRAO are the same as those of Branch Retinal Artery Occlusion.

Atherosclerosis is a buildup of plaque in blood vessels that can lead to blood clots in the retinal blood vessel.

Cardiac Emboli is a form of blood clots in the heart that travel to the retinal artery and become stuck and prevent blood flow.

Hypercoagulable states are medical conditions that increase the risk of blood clot formation, such as antiphospholipid syndrome and factor V Leiden deficiencies.

Giant cell arteritis is an inflammation of blood vessels that can cause blockage of the retinal vessel.

Trauma: A clot can form in the retinal vessel if there is an injury to the head or eye.

Vasculitis is an inflammation of blood vessels that can lead to narrowing or obstruction of the retinal vessel.

Carotid arterial stenosis: A narrowing of the carotid vein can lead to emboli that travel to the retinal bloodstream.

It is important to remember that CRAO can be caused by many factors. An ophthalmologist, along with other specialists, will need to examine the patient thoroughly in order to determine the cause of the problem and offer appropriate treatment.

What are the symptoms of Central Retinal Artery Occlusion

The symptoms of Central Retinal Artery Occlusion can vary depending upon the extent and location of the occlusion. However, they are usually:

Sudden, unremarkable loss of vision: This is most common symptom in CRAO. It can cause mild to severe vision loss and even complete blindness.

Visual field defects: This is the loss of vision in one eye. There is usually no peripheral vision.

Blurred vision: Although this is less common in BRAO than it is in BRAO. However, it can still occur when the occlusion has been partial. Color vision may change: Because the retina is not receiving enough blood, the affected area may appear grayish or white.

Redness in the eye may be caused by inflammation of blood vessels.

Headaches: Occlusion can cause headaches in some people.

Systemic symptoms: Other conditions, such as giant cell arthritis, can cause systemic symptoms like fever, malaise and jaw claudication.

What is the treatment for Central Retinal Artery Occlusion

Treatment for Central Retinal Artery Occlusion is usually focused on preserving vision and preventing further vision loss. Once CRAO has occurred, there is no treatment that can restore vision.

Treatment for emergency: In the event of CRAO being diagnosed early, intra-arterial thrombolysis and intra-arterial Papaverine injection may be used to dislodge the clot. These treatments are not available widely and can be considered invasive.

Anticoagulation and antiplatelet therapy can be used to stop emboli from spreading if the underlying cause of the emboli is a systemic one.

Low vision rehabilitation: This is recommended for patients with severe visual loss due to CRAO.

Ocular treatments: If the occlusion is due to a retinal embolism or laser therapy, surgery may be performed to remove it and restore blood flow. However, these procedures are not very successful.

Sanjeevan Netralaya's Advanced Ayurvedic Eye Care has effectively treated over 6 lakh patients across India and successfully treats Central Retinal Artery Occlusion without causing any harmful side effects or discomfort. Do if you have any symptoms of Branch Retinal Artery Occlusion, do not prolong your treatment. Book your appointment at your closest Sanjeevan Netralaya clinic today.

[nobelcast]

1938 - Corneille Heymans, Kan Basıncı

Corneille Jean François Heymans

Doğum: 28 Mart 1892, Gent, Flanders, Belçika

Ölüm: 18 Haziran 1968, Knokke, Flanders, Belçika

Biyografi: https://www.nobelprize.org/prizes/medicine/1938/heymans/biographical/

https://academic.oup.com/eurheartj/article/41/16/1531/5823549

https://www.mayoclinicproceedings.org/article/S0025-6196(12)65749-8/fulltext

https://www.frontiersin.org/articles/10.3389/neuro.05.023.2009/full

[voidcat]

as of recently i dont feel like finishing the p2 ( & the extra) for the vampire chuuya fic i had ('fangs dipped in wine') so in case anyone wants to hear how it'd proceed (or maybe write the rest on their own?), i'll try explaining:

about 6 days after your first encounter with chuuya, he returns- more like stumbles into your place (bc vampires need an invite to enter a place, something you didnt know, and he quite literally is hanging off your window, the dabbling of his feet dont do much to conceal the ridiculous and concerning scene. luckily it's not a busy night.)

a little talk here and there, he says he found you by chance bc he could spot your scent nearby, which you call "creepy", again, then he reveals the real reason he dropped by is bc he forgot to give you his address and assumed you'd not remember the way he directed you that night- he is right. no blood drinking or anything of the sort happens that night, which you find odd bc all honesty, you did expect a little demand from him but he is fully commited to the details of your arrangement.

the next day comes and weeks after it, it's usually a little talk, a little drinking (you whatever you want and him, your blood from the wrist or hand). more and more the meetings become frequent, a friendly dynamic takes over, you talk about your life and todays society (he is fascinated by how fast things are changing) and he answers your questions regarding creatures of the night, to his knowledge.

special abilities come up once or twice, with a little bat joke which he brushes off. one night he gets up and offering his hand to you, requests you to follow him, to the roof of his penthouse. and there, he asks you to hold on tight and try to stay as calm as you can, not overthink, and with that, he floats. and mind you, his place is one of the tallest in yokohama already, it is a surreal experince that night- the sky, the city and how the lights of the city seem to blur behind him, sparkling like stars as his face becomes all you can see in your focus.

after that the special abilities talk comes again (he is a little tipsy also getting more and more warmed up to you) he reveals his is like floating but actually has more to do with gravity. the details go through your head. you ask about what else is there, he confirms changing of forms (a triumph "Bat!" can be heard from you), enhanced senses, strenght, speed, clingling to surfaces be vertical or upside down, compelling. he is a little quiet as he says the last one, refuses to elaborate on it or tell funn stories (like he did with others) and instead gives you a stern look and ask you to avoid the name "dazai osamu" or any person you see in bandages. when you try to laugh off his extensive worry and how it'd be hard to spot bandages when the person is clothed, he just asks you to look for the neck, as it's more obvious. this topic never arises again.

then more time skip-ish. he first offers you to stay at his place instead, justifying he only works at night so neither of you would be in the other's way, and that the place isnt of much use to him any way and you deserve better than that crumpled place and your shitty landlord. reluctantly you agree. then implied time skip again (these are all days or few weeks btw) him drinking your blood by the time has moved from just being the wrist etc but he still sounds a little shy whenever you bring this up or joke. one day you offer him to drink from your neck, "it's winter, even if you leave a mark, my clothes will cover it dont worry" he just gets redder (if possible... whatever drop of blood he seemed to ahve in hs body rushes to his face, you think the flush suits him) when he tries to argue back, you then ask if drinking straight from the carotid has a different feelin g than other veins/arters, a meek "yes" is heard from him, and again you prompt him to try, that it is your own decision, your body to offer etc.

few days of this, yet the air between the two seemed to have gotten tense a little bit, he comes back later, "wakes up" earlier, and seems to do everything in his power to avoid you. a confrontation scene, you p much say you can leave if he doesnt want you around anymore bc its what seems to be happening in your eyes, he tries to explain thats not it but refuses to explain, your vpice gets louder, few more threats and some words of inconfidence/self doubts, then he just yells "i avoid you because i have these feelings inside me that i do not know what to do with or how you will react to!" so yea from now on u guys can assume make up make out whatever, kinda happily ever after.

edit: I don’t rmr if the og fic has it but if it doesn’t, there was supposed to be a convo revolving Chuuya still works (mafia stuff) and legit gets his earn from there. Reader jokes abt how other vampires (in media) don’t do any work and Chuuya admits “…I’m bad with math.” (Bc unless u had an inheritance from someone/somewhere, usually immortality’s one perk is u can invest in a small biz and it may take off in the near/far future, earning u lots of money etc etc. idk smt like that I don’t rmr the details of the convo a summary of the extra chapter that takes place after the p2:

normally i had picked which route to go with for the extra but atm i cant remember for the life of me so yea

[libidomechanica]

You said

Look by forced a new assault  to short and merry me  on our breast; when 

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was Florious bone, ȝif ȝe  no lotez Love, and, beasts, at the  sesed bysyde; she doubt if 

the pale? þen starry dared  their present revelry  expected in 

giving nauþer good government— never your leg, and  down. When þat þe late she 

devil days his example spoke  not though is white the  world nis not do, I foundary it 

me þin erde, his books. Still rank  his first times carotid-arters;  deeper, brings on a greate, and 

þe segge care, of that passd  to one his sparent  till I see—Ah, nobody 

know looks taughter like these kindling  newspapers—and oerlabour bate,  and the narrative 

villages, all  in her sometimes were  staues did ring pH this 

best, We questions. Our speak  our bosoms trace by time  there schal se intense 

with swered soon the  Muse at kyth, in these no stern  and þe hyȝe; wroþely been 

faute. They found the tertian partly  becalméd bar above. At the  was advice 

past, and all he is you:  two hand, and my wyf: I wroȝt to  double vales, riche was 

the advanced the  sages, thus lethal. had and still,  with a wrinkle, of 

the sigh the other  shriekd the flakes froze:  If I wroȝt for the sea 

rolld a little, Betty went, such  of us” Worse-conjurer,  Johnnys near-on tenures rose of 

myself it falling mine for  like a sea rolled “gravitation.  making in the 

Southe doth are the cash anchord  as if Death eagerness,  beside of þe frek vsed 

If he is receding  on honde in stumbleness,  stood and there she was 

hit nedez ar on there w as as yet they were  My ioy, be true. watz serued. receives 

in the  mountains. An ivory  stif innocent and the 

snitered, his honde, and  them in Black and built back  my heart, tho less her hero, 

but now this perishd, the  care in þe byȝt, and scarce- clad? Our diviner shame 

tone. Though fashion, I ken togedered.  Watch in Cupids cornfields  are wyth, you shall silver: by con 

he crew; and þe boles, dying day- hymn stood helpless, and roaring, for  ho had left, ȝe lenþe doubt we 

replyd I no more torne; dropt on  folde had drof including and drof  into dying some 

lasses fair! was grown and  layd hym one, be Gods delight,  with a petticoat. 

And to thy Courtly  by my soul. On a special  perceiving Towrs, which I have eat 

here the door, acorded at  the was pursued,  debate; but known somethings at hym þe 

wylde; queme he was one  for þe doubtle Greenwich  hade him in, as whyle 

waves, here; þer maid it (his  Morning at hit is in the  Turk, and you they bring parts 

in numerable dinner from  your life shoud be aged,  or do of his duer 

unconscience of bere bi bonk  ryȝt to his from nightlike  other Heaven store for 

instructed. Belovëd,  what with his hands:  no hung her to read— 

it may provinced valorous  and cured on along, live  winds,) or wheneer shape for 

a hundred  Thought to beneath ( such kindling, scribe Belisarius, and 

þe large dare in her was  not a mortals beguile  our love, my dainty 

is breeze the nights from  leaning how many throne. Ne  þe corbeles round that 

coyntlych high marbled al were,  þat þe luf not much to save  natural at you, that 

are not figures. Some they great strange  advancing; but serener trust now  sometimes at prys more, as 

if that before torments  lives to run, year were  reared beaus back again) the 

least prize; and I wasnt they  clime concert stranges cannot  faine wot, and poor you love?

[teachingrounds]

GCA can be an ophtho emergency

Half of patients with Giant Cell Arteritis (GCA) will have visual symptoms such as blurring, diplopia, hallucinations, or blindness. Because the most serious of these--anterior ischemic optic neuropathy (AION)--is a true ophthalmic emergency, with a risk for permanent visual impairment in as many as 20% of patients, you should treat the transmural vasculitis with steroids while a temporal artery biopsy is coordinated. 

The blindness from GCA is typically acute, painless, and permanent. Steroids can be tapered in 4-6 weeks but may need to be continued at low doses for ~2 years, as long as the side effects are not too great. Steroid-refractory cases might need another kind of cellular immune modulator such as tocilizumab, cyclosporine, or methotrexate. Antibody-targeted steroid-sparing agents such as rituximab are thought to be less effective. 

In addition to blindness, the risks of untreated GCA include coronary arteritis leading to myocardial infarction, carotid vasculitis causing TIA or stroke, and--because GCA is a large-vessel vasculitis--aortic dissection. The greatest risks for vascular morbidity and mortality are within the first month of diagnosis, while the first year of steroids brings risk for infection.

[boorgulameherthej]

Dr Boorgula Meher Thej -  Why migraine is harmful to health

Migraine has a prevalence of about 15% of the population, with women(18%) being more affected  than men (8%). Migraine is a severe headache that can last for hours or days. They frequently affect only one side of the head, resulting in moderate to severe palpitations, tremors, or severe pain. Migraine, a fairly disabling condition, is treated with rapid and preventive medications..

Dr. Meher Thej AIIMS has treated numerous migraine patients in his career. According to him, the pain of a single migraine headache usually only lasts for a few hours or days. But it will affect your health in many ways.

According to Dr. Boorgula Meher Thej, Migraine is a chronic condition characterized by episodic attacks of disabling headaches. Migraine pain is usually associated with other symptoms such as nausea, dizziness, and excessive sensitivity to light, noise, and smell. Numerous Migraine patients with chronic migraines will have additional problems that increase their tendency to headache: These covers depression, anxiety, other pain syndromes such as fibromyalgia, localized pain in the head and neck structures and conditions that cause 'metabolic' stress such as sleep apnoea or postural orthostatic tachycardia syndrome. Only about 20% of migraine sufferers experience an aura, usually before the onset of the headache (but usually not). Most aura is visual, consisting of a combination of positive visual events (floaters, flashes of light, zig-zag patterns, and so on) and negative phenomena (loss of vision blind spots). Many sufferers also experience sensory aura, often with tingling and numbness spread on one side of the body on the hands,  face, lips, and tongue. Weakness, dyspepsia and other aura symptoms are rare.

According to Boorgula Meher Tej, Thunderclap Headache and Persistent Worsening Headache are the other two common headache patterns (other than throbbing headache). Subarachnoid hemorrhage, Cerebral venous sinus thrombosis (CVST), Reversible cerebral vasoconstriction syndrome, Carotid/vertebral artery dissection, Pituitary apoplexy, Intracerebral hemorrhage/haematoma, Hypertensive encephalopathy, and Idiopathic thunderclap hemorrhage these are all causes of Thunderclap headache, and  Raised cerebrospinal fluid (CSF) pressure (tumor, abscess, CVST, idiopathic intracranial hypertension), Low CSF volume (post-lumbar puncture, spontaneous CSF leak), Meningitis (acute/chronic), Hypoxia/hypercapnia, Substance abuse/withdrawal, Systemic inflammatory conditions, including temporal arteritis, are all causes of persistent worsening headache.

How to relieve Migraine pain 

Migraine is the common cause of recurrent, severe headache. It is often difficult to identify specific triggers in patients suffering from chronic severe headaches. There are some first-line medications for migraines of mild to moderate severity. Pain relievers such as aspirin, paracetamol, ibuprofen, naproxen, diclofenac, phenazone, and tolfenamic acid can help. There are also other treatments available, such as Paradoxically it’s often the case that as chronic headaches start to boost with treatment, triggers become more obvious. Dietary regularity in relation to food, hydration, sleep, and stress is always helpful in reducing the tendency to migraine; Recognizing that this is helpful is simple, but making the expected changes in modern busy lives can be difficult. Migraine prophylaxis points to  reduce migraine frequency, severity and disability and improve quality of life.Chronic migraine patients require prophylactic therapy to reduce the frequency of migraine attacks.

According to Dr. Meher Thej AIIMS, some patients with low-frequency EM can be managed without prophylactic treatment with effective acute therapy (i.e. drugs taken during the prodrome or the migraine attack to abort it), but patients with Chronic Migraine invariably require prophylactic treatment. While acute therapy aims to abort a migraine attack, prophylactic treatment, once initiated, aims to prevent the attacks, reducing the frequency, severity, and associated disability of the headache and reliance on acute treatment, which may contribute to concurrent Medication-overuse headache(MOH).

About Dr. Boorgula Meher Thej

Dr. Boorgula Meher Thej is a neurosurgeon. He trained at AIIMS, New Delhi. He has experience in Neuro Oncology, Skull-Base Vascular Neurosurgery, Paediatric Neurosurgery, Functional-Epilepsy Surgery, Spine Surgery, and Neurotrauma. Boorgula Meher Thej's mission in life is to have a successful neurosurgical career involving all the aspects of neurosurgery, serve people, and grow himself.

[a4medicineuk]

Get Treatment of CKS Sinusitis Problem Today | A4Medicine

A blocked nose is frequently the most noticeable symptom (nasal obstruction) of CKS sinusitis. Read this blog to know more about various diseases with their symptoms.

Sinusitis

Sinusitis also possible that one or more of the following things happen:

Pain in the area of the damaged sinus. Pain, on the other hand, is not always a prominent hallmark of chronic sinusitis (unlike acute sinusitis). It’s more often than not a sensation of facial fullness or moderate discomfort, rather than pain.

Both viral and bacterial sinus infections have similar symptoms:

Nasal congestion

Thick, discolored nasal discharge that might be white, yellow, or green, as well as sinus pressure and facial pain that can get worse when you lean over.

Teeth hurting

Headache

Decreased smell or taste

Ear pressure or fullness

Bad breath

Ever less than 102 degrees

ADHD

While some adults with ADHD CKS have fewer symptoms as they get older, others continue to have substantial symptoms that interfere with daily life.

Symptoms of adult ADHD include:

Impulsiveness

Disorganization and problems prioritizing

Poor time management skills

Problems focusing on a task

Trouble multitasking

Excessive activity or restlessness

Poor planning

Low frustration tolerance

Frequent mood swings

Problems following through and completing tasks

Hot temper

Temporal Arteritis

Temporal arteritis CKS has an etiology that is unknown. Its etiology has been linked to many autoimmune, environmental, and genetic factors.

Temporal arteritis is a type of persistent vasculitis marked by granulomatous inflammation of the medium and large arteries’ walls. As a result, the clinical signs and symptoms seen vary depending on which vessel is affected. The carotid artery’s extracranial branches and the ocular artery are commonly impacted, but other aortic branches might also be involved.

Sinus infections can be caused by a number of things, but the symptoms and illness can be extremely painful and incapacitating. CKS sinusitis is caused by allergies, colds, flu, bacteria, and other pathogens. In most cases, the infection may be spontaneously drained out and the body can heal itself.

GCA, also known as CKS or Horton’s arteritis, is a T-lymphocyte-mediated inflammation that affects the internal elastic lamina and outer arteries of large and medium-sized arteries. It’s a medical emergency with major systemic and ocular implications. The most dangerous of familial hypercholesterolemia CKS is a rapid and progressive loss of vision that can be bilateral and irreversible.

Conclusion

CKS Sinusitis is a condition in which the sinuses enlarge as a result of an infection. It’s rather common, and it normally goes away on its own within 2 to 3 weeks. Medicines, on the other hand, can help if the problem is taking a long time to go.

[mcatmemoranda]

One of my pts has been C/O headache and he was worked up for giant cell arteritis (GCA). He was treated with prednisone. I remember he was also complaining of visual symptoms. I thought it might be a result of a recent stroke he had, but it didn't make sense given the side that he had the stroke on. Now that I'm reviewing and thinking about it, it makes sense. My attending told the pt to stop prednisone because his ESR and CRP came back normal, but these are non-specific tests, so it shouldn't be these that are used to diagnose. If I remember correctly from medical school, a temporal artery biopsy is the gold standard for diagnosis.

From UpToDate:

When to suspect giant cell arteritis – The diagnosis of giant cell arteritis (GCA, also known as Horton disease, cranial arteritis, and temporal arteritis) should be considered in a patient over the age of 50 years who complains of or who is found to have one or more of the following:

•A new headache •Abrupt onset of visual disturbances, especially transient/permanent monocular visual loss •Jaw claudication •Unexplained fever or anemia •Elevated erythrocyte sedimentation rate (ESR) and/or serum C-reactive protein (CRP) •Temporal artery abnormalities such as tenderness to palpation, decreased pulsation, presence of nodules

Any of these findings are of special concern in the context of a current or previous diagnosis of polymyalgia rheumatica (PMR) because of the association between GCA and PMR.

●Initial diagnostic evaluation

•Laboratory data – Laboratory data can aid in the evaluation of GCA and its differential diagnosis, but they are not specific and cannot be relied on as definitive evidence for or against a possible diagnosis of GCA. Initial laboratory testing should include the ESR and CRP levels, which are almost always high in GCA. However, normal acute phase reactants do not exclude the diagnosis of GCA.

•Assessment of the temporal artery – A suspected diagnosis of GCA should be confirmed by temporal artery biopsy or temporal artery color Doppler ultrasound (CDUS).

Scheduling the temporal artery biopsy or CDUS should not delay initiation of treatment with the appropriate dose of glucocorticoids in a patient with a high likelihood of GCA, since delay can put the patient at risk for complications, particularly sight loss.

Evaluation for large vessel GCA in patients with a nondiagnostic initial workup – When the diagnosis of GCA is still suspected in a patient who has had a negative temporal artery biopsy and/or CDUS, the possibility of large vessel involvement can be considered. The diagnostic procedure of choice for suspected large vessel GCA is an advanced imaging study of the aorta and/or its branches. Computed tomography (CT) or CT with angiography (CTA), magnetic resonance imaging (MRI) or MR angiography (MRA), and positron emission tomography (PET) or PET with CT are useful for the identification of large vessel GCA. CDUS of the epiaortic vessels (eg, carotid, subclavian, and axillary arteries) can also be used to diagnose large vessel vasculitis.

Diagnosis – The diagnosis of GCA should not be based on clinical presentation alone but should be premised on histopathologic proof or evidence from imaging exams. Occasionally clinicians are faced with the diagnostic challenge of a negative workup, which should include negative temporal artery biopsy or biopsies and, if indicated, imaging of the large vessels. In this situation, the clinician can choose to either:

-Conclude that the patient does not have GCA and pursue alternative diagnoses, or

-Make a clinical diagnosis of GCA and treat accordingly

Differential diagnosis – The differential diagnosis of GCA includes other vasculitides (eg, Takayasu arteritis, small- and medium-sized vessel vasculitides, primary angiitis of the central nervous system), nonarteritic anterior ischemic optic neuropathy (NAAION), and infection.

Postdiagnostic imaging evaluation in patients with cranial arteritis – We routinely screen for large vessel involvement in all patients with newly diagnosed cranial GCA by performing CDUS of the epiaortic vessels (eg, carotid, subclavian, and axillary arteries).

[letstalkhealth-blog1]

3 Types Of Headache That Requires Emergency Attention

Generally, headaches are not life-threatening, but a severe headache could be a signal for something much serious and requires emergency attention most times. 

You might take a headache with a levity hand but some headaches require further investigation so as to avoid the occurrence of serious sicknesses like stroke, aneurysm, and meningitis.

Below are the 3-types of headaches that need immediate attention, do have it at the back of your mind that there are more than 3-headache types that call for an urgent medical evaluation.

· Meningitis and Encephalitis Meningitis and Encephalitis are types of headaches that are infectious and calls for emergency treatment.  The symptoms accompanied by these headaches are a stiff neck, fever, altered menstrual status, and lethargy.  A CT scan and lumbar puncture are required for diagnosis. So if you are experiencing these symptoms it is crucial you see a doctor as soon as you can.

· Trauma-Related Headaches

Trauma-related headaches require urgent medical attention.  Head trauma headache is majorly known as a symptom of intracranial bleed. This is a type of headache cluster that could result in loss of consciousness if not properly taken care of. However, know that any trauma that results in a headache, especially if associated with nausea and vomiting, requires urgent medical attention.

· Temporal Arteritis

Temporal Arteritis is a type of headache that occurs in the temporal region of the head and is associated with an inflammatory process. This could result in vision complications and could result in a permanent sight loss.

Giant-cell arteritis is also an inflammatory disease of the blood vessels that involves large and medium arteries of the head. The most serious complication is occlusion or blockage of the ophthalmic artery, which is part of the internal carotid.

 It can cause a medical emergency that might result in an irreversible blood supply loss and blindness if neglected. Temporal arteritis is treated with steroids which help reduce inflammation and prevent blockages.

For Health Related issue visit Book Appointment or Consult with the Top Online Doctors at Ask Apollo.

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Best neurologist in shalimar bagh - Why migraine is harmful to health

Migraines have a lifespan in about 15% of the population, affecting women (18%) compared to men (8%). Migraines are acute, recurring headaches that can last for hours or days. They often affect one side of the head, causing moderate to severe palpitations, tremors, or severe pain. Migraine, a fairly disabling condition, is treated with acute and preventive medications.

Dr. Shailesh Jain handled many cases of migraines in his 15+ years of career. He said, the pain of a single migraine headache usually only lasts for a few hours or days. But this will affect your health in many ways.

According to Dr. Shailesh Jain AIIMS Neurosurgeon, migraine is a chronic condition characterized by episodic attacks of disabling headaches. Migraine pain usually lacks other characteristics such as nausea, dizziness, excessive sensitivity to light, noise, and smell. Hunger, disturbances of bowel function, etc. Numerous Migraine patients with chronic migraines will have additional problems that increase their tendency to headache: These covers depression, anxiety, other pain syndromes such as fibromyalgia, localized pain in the head and neck structures and conditions that cause 'metabolic' stress such as sleep apnoea or postural orthostatic tachycardia syndrome. Only about 20% of migraine sufferers experience a headache, usually before the onset of the headache (but usually not). Most aura is visual, consisting of a combination of positive visual events (floaters, flashes of light, zig-zag patterns, and so on) and negative phenomena (loss of vision blind spots). Many sufferers also experience sensory aura, often with tingling and numbness spread on one side of the body on the hands,  face, lips, and tongue. Weakness, dyspepsia and other aura symptoms are rare.

There are two typical patterns of headache such as Thunderclap headache and persistent worsening headache. Thunderclap headache causes Subarachnoid haemorrhage, Cerebral venous sinus thrombosis (CVST), Reversible cerebral vasoconstriction syndrome, Carotid/vertebral artery dissection, Pituitary apoplexy, Intracerebral haemorrhage/haematoma, Hypertensive encephalopathy, Hypertensive encephalopathy, and Idiopathic thunderclap haemorrhage (Call–Fleming syndrome). Persistent worsening headache causes Raised cerebrospinal fluid (CSF) pressure (tumour, abscess, CVST, idiopathic intracranial hypertension), Low CSF volume (post-lumbar puncture, spontaneous CSF leak), Meningitis (acute/chronic), Hypoxia/hypercapnia, Substance abuse/withdrawal, Systemic inflammatory conditions, including temporal arteritis.

How to relieve Migraine pain 

Migraine is the usual source of recurrent, severe headache. When patients have chronic severe headaches, it is often  difficult to acknowledge specific triggers. There are some drugs of first choice for migraines of mild or moderate severity. Aspirin, paracetamol, ibuprofen, naproxen, diclofenac, phenazone and tolfenamic acid can help to ease your pain. Also there are other treatments as well, such as,  Paradoxically it’s often the case that as chronic headaches start to boost with treatment, triggers become more obvious. Dietary regularity in relation to food, hydration, sleep, and stress is always helpful in reducing the tendency to migraine; Recognizing that this is helpful is straightforward, but it can actually be more difficult to make the expected changes in modern busy lives. Migraine prophylaxis points to turn down migraine frequency, severity and disability and improve quality of life. Chronic migraine patients require prophylactic therapy to lessen the frequency of migraine attacks, but presently available evidence-based prophylactic treatment options for chronic migraine are topiramate and onabotulinumtoxinA.

Some patients with low-frequency EM can be managed with effective acute therapy(i.e. drugs taken during the prodrome or the migraine attack to abort it) without prophylactic treatment, but patients with Chronic Migraine invariably require prophylactic treatment. While acute therapy aims to prevent a migraine attack, once initiated, the goal of prophylactic treatment is to stop the attacks, reducing the frequency, severity, and associated disability of the headache and reliance on acute treatment, Which may contribute to concurrent MOH(Medication-overuse headache). 

About Dr. shailesh jain 

Dr. Shailesh Jain is the Best neurologist in shalimar bagh. He is a principal consultant neurosurgeon and stroke interventionist at Max Hospital Shalimar Bagh and runs his own Arihant Neurospine clinic in Rohini and Pitampura. 

You can Book an appointment for any kind of spinal cord Treatment as well as Brain Treatment.

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Successful Tocilizumab Treatment in a Child With Refractory Takayasu Arteritis

(1)Refractory Takayasu Arteritis abstract Takayasu arteritis (TA) in the child remains a therapeutic challenge because corticosteroids and conventional immunosuppressive agents are not always safe or efficacious. The complex formed by interleukin-6 (IL-interleukin-6) and soluble IL-interleukin-6 receptor appears to play a pivotal role in the pathogenesis of TA. We describe a favorable response to the anti-IL-6 receptor antibody tocilizumab (TCZ) in a child with aggressive and refractory TA including an assessment of the proinflammatory cyto-kine profile. A 3-year-old girl with TA consisting of thickening of the aortic arch wall, severe obstruction of the supra-aortic branches, and complete occlusion of both common carotid arteries failed to respond to corticosteroids, methotrexate, tumor necrosis factor a blockade, cyclophosphamide, and mycophenolate mofetil, and 3 years later, the disease remained active with severe manifestations (brain ischemia). The patient underwent percutaneous angioplasty, although significant restenosis was soon documented. After a severe relapse, the patient started TCZ infusions (8 mg/kg for 2 weeks), and a rapid clinical remission was observed, associated with a drastic reduction of in-flammatory markers and IL-6 levels. Corticosteroids were withdrawn, the patient’s weight and height improved, and bone mineral density values returned to normal. Two years later, TCZ infusions were ex-tended, with no significant side effects. Cerebral ischemia resolved, and recanalization of the previously occluded supra-aortic branches was performed.Pediatrics2012;130:e1720–e1724 AUTHORS:Beatriz Bravo Mancheño, MD, PhD,aFrancesca Perin, MD,bMaría del Mar Rodríguez Vázquez del Rey, MD,b Antonio García Sánchez, MD,cand Pedro Pablo Alcázar Romero, MD, PhDd aPediatric Rheumatology Unit,bPediatric Cardiology Unit, Pediatrics Department;cRheumatology Department; and dInterventional Neuroradiology Unit, Radiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain KEY WORDS vasculitis, Takayasu arteritis, pediatrics, interleukin-6, tocilizumab, TNFa, methotrexate, cyclophosphamide, mycophenolate mofetil ABBREVIATIONS CRP—C-reactive protein CYC—cyclophosphamide ESR—erythrocyte sedimentation rate IL-6—interleukin-6 LVV—large-vessel vasculitis MMF—mycophenolate mofetil MRA—magnetic resonance angiography MTX—methotrexate PCTA—palliative percutaneous transluminal angioplasty SAA—serum amyloid A TA—Takayasu arteritis TNF-a—tumor necrosis factora TCZ—tocilizumab www.pediatrics.org/cgi/doi/10.1542/peds.2012-1384 doi:10.1542/peds.2012-1384 Accepted for publication Jul 23, 2012 Address correspondence to Beatriz Bravo Mancheño, MD, PhD, Unidad de Reumatología Pediátrica, Servicio de Pediatría, Hospital Universitario Virgen de las Nieves, Avenida de las Fuerzas Armadas, 2, 18014 Granada, Spain. E-mail: beatrizbravo. m@gmail.com PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Copyright © 2012 by the American Academy of Pediatrics FINANCIAL DISCLOSURE:Dr Alcazar Romero declares a consultancy with Johnson & Johnson Company; the others authors have indicated they have nofinancial relationships relevant to this article to disclose.

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“dysi reptiles dont have carotid arter-“

GET OFF MY ASS

[theannuityexpert]

Life Insurance After a Stroke

Researching how to get life insurance after having a stroke? In this guide, we'll go over what you need to know to get coverage then work with you directly to shop life insurance quotes and get you insured at the lowest cost possible.

Transient Ischemic Attacks (TIAs) and Strokes (CVAs)

Obstruction in blood flow (ischemia) to the brain can lead to permanent damage. This is called a cerebrovascular accident (CVA). It is also known as cerebral infarction or stroke. If the symptoms are temporary without permanent brain damage, the event is called a transient ischemic attack (TIA). Rupture of an artery with bleeding into the brain (hemorrhage) is called a CVA, too. Strokes and TIAs are rated based on the underlying cause. The most common cause of TIAs and CVAs is hypertensive and atherosclerotic plaque within the arteries to the brain (aka cerebrovascular disease or CVD). Cerebrovascular Disease can be complicated by clots (thrombosis) and by emboli from the heart. Because CVD is an indicator of atherosclerosis in other parts of the body, an individual with a history of TIA or CVA is at risk for coronary artery disease and recurrent stroke. Risk factors for CVD include: SmokingCoronary artery diseaseHigh blood pressureDiabetesLipid disorders (such as high cholesterol) Peripheral arterial diseaseAtrial fibrillation Signs and symptoms of a CVA/TIA include: WeaknessNumbnessHeadachesDizzinessNauseaVomitingParalysis of one side of the bodySpeech difficultyMemory defectsAmaurosis fugax, a form of visual TIA, is temporary monocular (one eye) or partial blindness. Tests are done to evaluate brain circulation, such as a carotid ultrasound (Duplex) or an angiogram (MRA). A brain scan (CT and/or MRI) is used to determine if an individual has had a stroke. A TIA will not show on a scan. TIA is never ruled-out by negative tests; diagnosis is adequately met by symptoms only. Although CVAs, TIAs, and bleeding into the brain are mainly due to atherosclerosis or hypertension, there are many non-atherosclerotic causes: MigraineAdverse drug reactionsTraumaRuptured congenital aneurysmValvular heart diseaseCongenital heart diseaseClotting disordersConnective tissue disease (example lupus)And others At times, no cause can be found in young individuals. This is termed “cryptogenic.” Cryptogenic events over age 55 are assumed to be atherosclerotic. The long term prognosis varies depending on the cause, and additional tests (such as an echocardiogram, clotting studies, and other blood and imaging tests) may be required to determine rare etiologies.

Treatments for Strokes

Treatment for CVD includes physical and speech rehabilitation for any residual impairment, blood thinners (like aspirin or Coumadin), cholesterol-lowering medications, and blood pressure control. Surgical treatment (endarterectomy or stent) may be used to open the obstruction.

Underwriting

A general idea of ratings in the life insurance underwriting process for TIA/CVA can vary from insurance company to company. Any adjustments both up or down in ratings will depend on the underlying cause, the extent of permanent neurological impairment, treatment, and the quality of risk factor modification. Acceptable cases have minimal residuals, normal mentation, and a return to full activity. You should know more than two events, dementia, or significant residual physical or mental impairment are declined. Non-atherosclerotic causes of a stroke include aneurysms, vascular malformations, trauma, clotting disorders, emboli from abnormal heart structures, vasculitis/arteritis, adverse drug events (warfarin, birth control pills, cocaine, amphetamine, etc.), fibromuscular dysplasia, spontaneous dissection. Risk assessment in Life underwriting depends on the underlying cause. Factors in the Decision Process Age of the applicant when the stroke or TIA occurredNumber and date of occurrencesDegree of neurological impairmentPresence of other health concerns including coronary artery disease, diabetes, peripheral vascular disease, poorly controlled. Guidelines for Coverage Occurrences under the age of 40 are typically declined.After 3 months of the last occurrence can be considered for coverage depending on the severity of the stroke.

Free Life Insurance Consultation

Frequently Asked Questions

Does life insurance cover stroke? Under specific circumstances, you can get coverage. If you feel your health could prevent you from being approved for a life insurance policy, contact us. Very rarely can we not find a solution for most people. Read the full article