LUMBAR SPONDYLOLISTHESIS

LUMBAR SPONDYLOLISTHESIS IS THE FORWARD SLIP OF ONE VERTEBRA TO ANOTHER. THIS IS USUALLY FOUND IN THE LUMBAR REGION. SPONDYLOLITHESIS IS DESCRIBED ON ITS DEGREE OF SEVERITY. G-1 25% OF THE VERTEBRAL BODY HAD SLIPPED. G-2 50%, G-3 75%, G-4 100%, AND G-6 THE VERTEBAL BODY HAS COMPLETELY FALLEN OFF.

PEOPLE AFFECTED BY LUMBAR SPONDYLOLISTHEIS ARE USUALLY INVOLVED WITH VERY PHYSICAL ACTIVITIES. EXAMPLES OF THIS WOULD BE WEIGHTLIFTING, GYMNASTICS, AND FOOTBALL.

SYMPTOMS OF LUMBAR SPONDYLOLISTHESIS INCLUDE LOW BACK PAIN, INCREASED LORDOSIS, PAIN THE LEGS. THESE SYMPTOMS CAN LEAD TO AN ALTERED WALK AND STANCE.

TEST USED TO DIAGNOSE SPONDYLOLISTHEIS ARE XRAYS. IF SPONDYLOLITESIS IS SEEN, THEN A POST-MYELOGRAM CT IS PERFORMED. THIS CT EXAM WILL EVALUATE THE STRUCTURE OF THE SPINE AND THE CONTRAST ENHANCED IMAGES WILL SHOW IF THE AFFECTED VERTEBRAE ARE PRESSING ON NERVES.

TREATMENT IS DEPENDANT ON THE SEVERITY OF THE SPONDYLOLISTHESIS. TREATMENT CAN RANGE FROM REST, TO WEARING A BRACE, TO SURGERY. IF SURGERY IS PERFORM, HARDWARE IS USED TO PULL THE VERTEBRAL BODY BACK INTO ALIGNMENT. CAGES ARE ALSO PLACED IN THE DISC SPACE.

Thoracic Disc Herniation

Herniation of a disc occurs when the nucleus pulposus leaks out of the inside of the disc. The disc then pushed into the spine cord. This is usually caused by trauma to the upper back, or degenerative disc disease.

Symptoms of a thoracic disc herniation usually include upper back pain. This pain can radiate into the arms, chest, and belly.

Pain radiographs will not show a disc herniation. A MRI is the most useful study to show a herniated disc. If a MRI is contraindicated, then a post-myelogram CT should be done.

Most thoracic disc herniations can be treated without surgery. Rest, medication, and strength exercises are most often prescribed. Surgery is only done if the herniation lead to myelopathy or intolerable pain.

FRACTURES OF THE AXIS (C2)

FRACURES OF THE AXIS OR C-2 USUALLY OCCUR AS A RESULT OF SOME KIND OF TRAUMA. THE TRAUMA CAN BE A SUDDEN, SEVERE TWISTING OF THE NECK, OR A SEVERE BLOW TO THE BACK OF THE HEAD OR NECK. MOTOR VEHICLE ACCIDENTS, FALLS, AND SPORTS INJURIES ARE THE MOST COMMON CAUSES OF C-2 FRACTURES.

SYMPTOMS INCLUDE PAIN AT THE POINT OF INJURY. BRUISING AND SWELLING. PAIN AND NUMBNESS DOWN THE NECK AND INTO THE SHOULDERS. IF THE DENS OF C-2 IS FRACTURED, THERE MAY BE PARALYSIS FROM THE NECK DOWN.

NO MATTER THE SEVERITY OF THE FRACTURE, IMMOBILIZATION OF THE NECK IS DONE. A SEVERE FRACTURE OF ONE INVOLVING THE DENS MAY LEAD TO SURGERY. IMMOBILIZATION CAN BE AS SIMPLE AS A COLLAR, TO TRACTION WITH WEIGHTS AND A PULLEY, TO A HALO BRACE.

WITH PROPER IMMOBILIZATION AND HEALING A FULL RECOVERY FROM A C-2 FRACTURE IS POSSIBLE.

CAROTID ARTERY STENOSIS

CAROTID STENOSIS IS A NARROWING OF THE INNER LUMEN OF THE CAROTID ARTERY, USUALLY CAUSED BY A BUILDUP OF PLAQUE. THE PLAQUE CAN BUILD UP AND CAUSE A COMPETE BLOCKAGE. SOMETIMES SOLID PIECES CALLED EMBOLI CAN BREAK OFF AND TRAVEL THROUGHT THE BLOOD VESSELS TO THE BRAIN. THIS CAN RESTRICT OR BLOCK BLOOD FLOW TO THE BRAIN WHICH CAN LEAD TO A TRANSIENT ISCHEMIC ATTACH, OR A STROKE.

SYMPTOMS INCLUDE WEAKNESS OR NUMBNESS TO A LIMB OR ONE SIDE OF THE BODY. LOSS OF SIGHT IN ONE EYE. ARTERY SOUNDS, AND RINGING IN THE EAR.

DIAGNOSES IS USUALLY DONE FROM EITHER A DUPLEX ULTRASOUND, A COMPUTED TOMOGRAPHY ANGIOGRAM , OR A MAGNETIC RESONANCE IMAGING ANGIOGRAM. SOMETIMES AN ANGIOGRAM IN THE SPECIAL PROCEDURES DEPARTMENT IS ALSO PERFORMED.

TREATMENT FOR CAROTID STENOSIS INCLUDE ANTIPLATELET DRUGS. A PROCEDURE WHERE A CAROTID STENT IS PLACED. AND WHEN NEEDED, A SURGERY TO REMOVE THE AFFECTED AREA CALLED A CAROTID ENDARTERECTOMY IS DONE.

SOFT TISSUE ABSCESS OF THE NECK

A SOFT TISSUE ABSCESS IS A COLLECTION OF PUS FROM AN INFECTION. AS THE INFECTION INCREASES, THE PRESSURE FROM THE INCREASED SIZE OF THE PUS COLLECTION PUSHES AGAINST NECK STRUCTURES SUCH AS THE THROAT AND TONGUE.

AN ABSCESS USUALLY FOLLOWS A BACTERIAL OR VIRAL INFECTION OF THE HEAD OR NECK. EXAMPLES OF THESE INCLUDE: A COLD, TONSILLITIS, SINUS INFECTION, OR EAR INFECTION. AS THE INFECTION WORSENS IT SPREADS DEEP INTO THE SOFT TISSUES OF THE NECK.

SYMPTOMS OF A SOFT TISSUE NECK ABSCESS INCLUDE: FEVER, SORE THROAT, SWELLING TO THE THROAT OR NECK, EAR PAIN, NECK PAIN AND STIFFNESS. IN SEVERE CASES A PERSON MAY EXPERIENCE DIFFICULTY BREATHING OR SWALLOWING.

BLOOD TESTS, THROAT CULTURE, AND XRAYS MAY ALL BE PERFORMED TO DIAGNOSE A SOFT TISSUE NECK ABSCESS. CT AND MRI THE BEST DIAGNOSTIC TOOLS TO EVALUATE FOR AN ABSCESS. WITH MRI HAVING THE BEST SOFT TISSUE RESOLUTION.

TREATMENT USUALLY INVOLVES ANTIBIOTICS. IF NEEDED THE ABSCESS CAN BE DRAINED VIA A NEEDLE.

CEREBRAL ANEURYSM

A CEREBRAL ANEURYSM IS A BULGE OR BALLOONING IN A BLOOD VESSEL OF THE BRAIN. IT OFTEN LOOKS LIKE A BERRY HANGING ON A BRANCH. AN ANEURYM CAN RUPTURE, CAUSING A BLEEDING INTO THE BRAIN.

SYMPTOMS

SYMPTOMS OF AN UNRUPTURED ANEURYMS INCLUDE: PAIN ABOVE THE EYE, DILATED PUPIL, VISION CHANGES, NUMBNESS AND OR WEAKNESS TO ONE SIDE OF THE FACE.

SYMPTOMS OF A RUPTURED ANEURYMS INCLUDE: A SUDDEN SEVERE HEADACHE, NAUSEA/VOMITING, VISION CHANGES, SEIZURE, CONFUSION AND LOSS OF CONSCIOUSNESS.

BOTH CT AND MRI ARE OFTEN DONE WHEN A CEREBRAL ANEURYSM IS SUSPECTED. A CT SCAN MAYBE DONE INITIALLY TO DETERMINE IF THE IS A BRAIN BLEED. A MRI OR MRA IS DONE TO GET BETTER AND MORE DETAILED IMAGES OF THE ANEURYSM. A NEUROSURGEON WILL USE THIS INFORMATION TO HELP DETERMINE A COURSE OF ACTION.

TREATMENT USUALLY INVOLVES SURGERY. A NEUROSURGEON REMOVES A SMALL PIECE OF THE SKULL TO ACCESS THE ANEURYSM. A CLIP IS THEN PLACED AROUND THE ANEURYSM TO CUT OFF BLOOD FLOW TO THE BULGING AREA. THE SIZE AND LOCATION OF THE ANEURYSM, ALONG WITH THE HEALTH AND AGE OF THE PATIENT ARE FACTORS IN DETERMINING IF SURGERY IS THE APPROPRIATE TREATMENT.

SINUSITIS

SINUSITIS IS AN IMMFLAMATION OF THE SINUSES AND NASAL AIRWAYS. SINUSITIS IS CLASSIFIED AS EITHER ACUTE (SUDDEN ONSET), OR CHRONIC (LONG TERM).

SYMPTOMS OF SINUSITIS INCLUDE HEADACHE, PRESSURE IN THE EYES, PRESSURE TO THE NOSE OR CHEEKS. ONCE THE INFECTION SETS IN A PERSON MAY HAVE A FEVER, NASAL CONGESTION, COUGH AND SORE THROAT.

XRAYS AND CT SCANS ARE THE METHOD OF DIAGNOSIS. THE SCAN WILL SHOW AIR FLUID LEVELS WITHIN THE SINUSES AND OR A THICKENING OF THE MUCOUSAL LINING OF THE SINUSES.

THE MOST COMMON TREATMENT IS ANTIBIOTIC MEDICATION. OCCASIONALLY A FLUSHING OF THE SINUSES IS DONE IN AN ATTEMPT TO CLEAN OUT THE INFECTED SINUS. SOMETIMES SURGERY IS THE RECOMMENDED OPTION. SURGERY IS DONE TO REMOVE NASAL POLYPS, OPEN NASAL PASSAGEWAYS, AND IN NEEDED, STRAIGHTEN THE NASAL SEPTUM.

ORBITAL FRACTURE

ORBITAL FRACTURE

ORBITAL OR BLOWOUT FRACTURES REFER TO FRACTURES OF THE ORBITAL RIM OR FLOOR OF THE ORBIT. THESE INJURIES USUALLY OCCUR WHEN A BLUNT OBJECT HITS THE EYE SUCH AS A FIST OR A BALL. THIS CAN CAUSE FLUID TO FILL THE MAXILLARY SINUS, OR IN SEVERE CASES, WHEN THE RIM OF THE ORBIT IS FRACTURED, THE EYE BALL ITSELF CAN SLIP OUT OF ITS NORMAL POSITION WITHIN THE SOCKET.

SYMPTOMS INCLUDE PAIN AND SWELLING. ALSO, DOUBLE VISION, ALTERED SENSATION TO THE AFFECTED EYE, AND SUNKEN EYE (ENOPHTHALMOS). SINUS PAIN AND PRESSURE ALONG WITH NASAL CONGESTION ARE ALSO SYMPTOMS OF A BLOWOUT FRACTURE OF THE ORBITAL FLOOR.

ALTHOUGH XRAYS CAN BE PERFORMED, CT IS THE PREFERRED METHOD OF DIAGNOSIS. AXIAL, CORONAL, AND SAGITTAL IMAGES ARE USED BY THE RADIOLOGIST TO DIAGNOSE.

DEPENDING ON THE SEVERITY OF THE INJURY, SURGERY MAY BE REQUIRED TO REPAIR AN ORBIT FRACTURE. IF THE ORBITAL RIM IS NOT COMPROMISED AND THE EYE BALL IS IN PLACE THEN SURGERY IS USUALLY NOT DONE.

PITUITARY TUMOR

THERE ARE SEVERAL SYMPTOMS OF PITUITARY TUMORS. THESE INCLUDE ABNORMAL GROWTH PATTERNS IN CHILDREN, HEADACHE, AND VISION PROBLEMS.

VISION PROBLEMS ARE THE MOST COMMON SYMPTOM. A PATIENT WILL USUALLY VISIT AN EYE DOCTOR WHO WOULD NOTICE THE TUMOR ON AN EXAM. MRI IS THE TEST MOST OFTEN ORDER FOR SUSPECTED PITUITARY TUMOR BECAUSE OF THE SUPERIOR CONTRAST OFFERED COMPARED TO A CT.

TREATMENT OF A PITUITARY TUMORS VARY BASED ON THE SIZE, LOCATION AND TUMOR TYPE. 60-70 PERCENT OF SMALL TUMORS REQUIRE NO TREATMENT. PERIODICAL OBSERVATION TO ENSURE THE TUMOR IS NOT GROWING IS RECOMMENDED. MEDICATION IS ANOTHER TREATMENT OPTION. DIFFERENT TYPE OF MEDICATIONS WORK TO BLOCK HORMONE SECRETION, WHILE OTHER MEDICATIONS SHRINK THE TUMOR SIZE. SURGERY IS OFTEN REQUIRED FOR LARGER TUMORS. BUT THIS IS ALSO DEPENDANT ON TUMOR TYPE, SIZE, AND LOCATION. RADIATION TREATMENTS CAN BE USED IF SURGERY IS NOT DONE OR IF A TUMOR RETURNS.

PRESBYCUSIS

PRESBYCUSIS, OR HEARING LOSS IS A COMMON PROBLEM THAT AFFECTS MILLIONS OF PEOPLE EVERY YEAR. COMMON SYMPTOMS ARE PAIN AND LOSS OF HEARING. THIS CAN BE CAUSED BY SEVERAL FACTORS INCLUDING HEREDITY, EARWAX BUILD UP, AND CHRONIC EXPOSURE TO LOUD NOISES. THE MOST COMMON CAUSE IS DAMAGE TO THE INNER EAR. THIS COULD BE FROM EAR INFECTIONS, TUMORS, ABNORMAL BONE GROWTH, OR A RUPTURED EAR DRUM.

DIAGNOSIS IS USUALLY FOUND FROM PERFORMING HEARING TESTS AND WHEN APPROPRIATE A CT SCAN OF THE IAC. TREATMENT FOR HEARING LOSS CAN BE AS SIMPLE AS REMOVING EARWAX TO WEARING HEARING AIDS, TO COCHLEAR IMPLANTS.

I HAVE DECIDED TO DISCUSS STROKES FOR MY PATHOLOGICAL CONDITION. STROKES ARE THE THIRD LEADING CAUSE OF DEATH IN THE U.S. THERE ARE 600,000 NEW OR RECURRENT STROKES EACH YEAR.

SYMPTOMS OF A STROKE INCLUDE TROUBLE WALKING, SPEAKING, SEEING, AND A HEADACHE. ALSO, PARALYSIS OR NUMBNESS ON ONE SIDE OF THE BODY.

STROKES ARE CLASSIFIED INTO TWO MAJOR GROUPS: ISCHEMIC AND HEMORRHAGIC. HEMORRHAGIC STROKE ARE DUE TO RUPTURE OF A CEREBRAL BLOOD VESSEL THAT CAUSES BLEEDING AROUND OR INTO THE BRAIN. HEMORRHAGIC STROKES MAKE UP 16% OF ALL STROKES. ISCHEMIC STROKES, WHICH ACCOUNT FOR 84% OF ALL STROKES, ARE SUBDIVIDED INTO FOUR CATEGORIES: THROMBOTIC, EMBOLIC, LACUNAR, AND HYPOPERFUSION INFARCTIONS.

A THROMBOTIC STROKE HAPPENS WHEN A CLOT FORMS WITHIN A CEREBRAL ARTERY. AN EMBOLIC STROKE OCCURS WHEN A DETACHED BLOOD CLOT, USUALLY FROM THE HEART, FLOWS INTO AND BLOCKS A CEREBRAL ARTERY. A LACUNAR INFARCTION IS WHEN THE SMALL ARTERIES IN THE BRAIN THICKEN CAUSING AN OCCLUSION OF THE ARTERY. HYPOPERFUSION INFARCTIONS OCCUR FROM RESPIRATORY OR CARDIAC FAILURE.

MEDICATION IS THE STANDARD TREATMENT FOR STROKES. TISSUE PLASMINOGEN ACTIVATOR (TPA) IS A CLOT-BUSTING DRUG USED TO DISSOLVE THE BLOOD CLOT CAUSING THE STROKE. ALSO, ANTICOAGULANTS, E.G. HEPARIN, AND ANITPLATELET DRUG ARE USED. SURGERY IS A FINAL OPTION.

FOLLOWING A STROKE 50 TO 70 PERCENT REGAIN A USABLE AMOUNT OF FUNCTION. 15 TO 30 PERCENT ARE PERMANENTLY DISABLED. THREE MONTHS AFTER A STROKE 20 PERCENT REQUIRE INSTITUTIONAL CARE.

Labels: HEAD PATHOLOGY