Monday, November 30, 2009

INFECTIOUS DISEASE OF BRAIN

INFORMATION ABOUT MENINGITIS


  • MENINGITIS


Meningitis is an infection of the covering layers of the brain (meninges). Meningitis can be caused by various sorts of infection, with a virus, with a bacterium, and even with fungi.

  • Viral meningitis is usually considered to be benign, and is a fairly common complication of virus infections. There is no specific treatment.

  • The three main causes of bacterial meningitis have been:

    • Haemophilus Influenzae type b (Hib),
    • Meningococcus, and
    • Pneumococcus.

    In Britain, the introduction of a Hib vaccination has led to a virtual eradication of Hib meningitis. The other two are left as the major causes of bacterial meningitis.


  • SYMPTOMS

The patient usually begins to feel vaguely unwell and may develop headache and a raised temperature(fever).There may also be vomiting. Unfortunately many ordinary germs start in this way, and certain other features can help to alert us to the possibility of meningitis.

It is important not to be over anxious, but if in doubt it is better to discuss with your doctor. More suspicious symptoms include:

  • neck and back stiffness,
  • over-sensitivity to light (photophobia),
  • severe headache, and
  • drowsiness.

Occasionally, in meningococcal meningitis, diarrhoea and/or a rash occur. Sometimes a fit or seizure may take place.

The rash

If there is a rash it is worth trying the "glass test" as you may have seen on the television. This involves pressing a glass tumbler against the rash to see if the red spots disappear under pressure. The rash of meningococcal meningitis does not disappear on application of pressure.


  • WHAT TO DO


If in doubt about a child or other member of the family, it is better to call the doctor and do mention your concerns to the doctor or his answering service. If the doctor has been consulted, but the patient seems to be deteriorating rapidly in a way not predicted by the doctor, it is worth ringing again.

Should your doctor consider that this is a case of meningitis he is likely to give an injection of penicillin and arrange emergency admission to hospital.


  • TREATMENT


Bacterial meningitis and meningococcal septicaemia are medical emergencies and need immediate treatment with antibiotics, together with admission to hospital. Some people will be cared for on a general ward, with close observation. Others may need to be cared for in an intensive care unit where their condition can be more closely monitored. The length of time spent in hospital varies depending on the severity of the disease.

Viral meningitis is rarely life-threatening, but can still make people very unwell. Most people with viral meningitis recover without needing hospital treatment.

Those who do need admission to hospital are treated with pain relief and rest. As with bacterial meningitis, the length of time spent in hospital will vary.


  • PREVENTION


People who have been in contact with a confirmed case of meningitis will be offered treatment, to protect them. This will mean antibiotic tablets, possibly with the addition of an injection if the infection is the sort for which there is a vaccine. It is likely that the public health doctors will arrange this, but if you are in doubt, ask your doctor.

If prospective students have not received a meningitis vaccination, they should check with their doctor in good time, so that they can have the vaccination, if that is required, before they enjoy their long Summer vacation.

Students living in communal residences should be aware of the above symptoms in themselves or their friends, and call the doctor or student health service if worried.

Sunday, November 29, 2009

CEREBRO VASCULAR ACCIDENT

STROKE;AN HYPERTENSIVE DISORDER



  • INTRODUCTION

A stroke happens when the blood supply to the brain is interrupted. It's sudden and can cause immediate loss of feeling and weakness, usually on one side of your body. A stroke can also affect your speech, vision, memory and emotions.


  • TYPES OF STROKE

1.Ischaemic stroke happens when the blood supply to part of the brain is blocked by a blood clot or a piece of fatty material

2.Haemorrhagic stroke is caused by bleeding inside the brain. This can be due to a blood vessel bursting inside the brain, or, more rarely, on the surface of the brain.

3.Transient ischaemic attack (TIA or "mini-stroke") is similar to a stroke, except the symptoms are only temporary. TIAs happen when the blood supply to the brain is interrupted for a short time


  • SYMPTOMS OF STROKE

The symptoms of a stroke vary depending on the type of stroke you have had and the part of the brain it affects. Symptoms usually come on suddenly, within seconds or minutes. Rarely, the symptoms can get worse over a period of hours or days.

Stroke and TIA symptoms may include:

  • numbness, weakness or inability to move your face, arm or leg on one side of your body
  • difficulty speaking
  • sudden loss of sight in one eye or blurred vision
  • confusion or difficulty understanding
  • loss of balance or coordination
  • severe headache
  • seizures
  • loss of consciousness

  • COMPLICATIONS

One of the main effects of stroke is not being able to move some or all of your body, as the parts of the brain involved in controlling movement have been damaged. This immobility can increase the chances of getting:

  • pneumonia
  • pressure sores
  • constipation
  • deep vein thrombosis (DVT)
  • contractures (altered position of the hands, feet, arms or legs due to muscle tightness)

Other complications of stroke can include seizures (fits) - especially in the weeks and months after the stroke.


  • RISK FACTORS


Risk factors for stroke include:

  • smoking
  • high blood pressure
  • high cholesterol
  • being overweight or obese
  • diabetes
  • a family history of stroke/heart disease
  • abnormal heart beat (arrhythmia)
  • conditions that increase your bleeding tendency (eg haemophilia)
  • regular, heavy drinking
  • using illegal drugs, such as cocaine

  • DIAGNOSIS


You will have a brain scan (a CT scan or an MRI scan) as soon as possible after you have had a stroke to work out what type of stroke you have had and which part of your brain is affected. You may also need to have other scans of your heart and blood vessels.

Your doctor will try to find out why the stroke happened so you can have treatment to prevent further strokes in the future. You may have tests to detect:

  • raised blood pressure
  • high cholesterol
  • diabetes
  • irregular heart rhythms
  • blood clotting abnormalities

  • TREATMENT

Your doctor may prescribe medicines soon after your stroke. If you have had an ischaemic stroke or a TIA, these may include medicines to prevent further blood clots, such as aspirin or clopidogrel. If you have had a haemorrhagic stroke, you may be given medicines to promote blood clotting and reduce bleeding and/or medicines to control your blood pressure.

You may sometimes be offered surgery to reduce your risk of having another stroke. This will depend on the type of stroke you have had.