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Tang Bo
Neurology
About me
Studied for a master's degree at the Second Affiliated Hospital of Harbin Medical University and currently works at Nanshan District People's Hospital in Shenzhen.
Proficient in diseases
Specializes in neurology diseases related to cerebral infarction, myasthenia gravis, Guillain-Barré syndrome, epilepsy, Parkinson's disease, dizziness, migraines, and neurosis.
Voices
What foods should not be eaten in the case of a cerebral infarction?
Stroke refers to the necrosis of brain tissue, causing a series of neurological functional deficit symptoms. The dietary requirements for stroke must be determined comprehensively based on the patient's own condition and underlying diseases. For instance, common risk factors for stroke include hypertension, diabetes, hyperlipidemia, and elevated homocysteine levels, along with unhealthy habits such as smoking and drinking. If the patient has hypertension, a light diet should be emphasized. If they have hyperlipidemia, fatty foods should be avoided in favor of a low-fat diet. In cases of high homocysteine levels, it is advisable to consume foods rich in vitamins. Additionally, if the patient has diabetes, they must adhere to a diabetic and low-sugar diet. Therefore, what food can be consumed depends on the patient's underlying diseases and the symptoms of the stroke. If the patient has swallowing difficulties, care must be taken to avoid hard foods as this could lead to choking and potentially cause a lung infection. Thus, the patient's individual condition must be taken into account when deciding their diet.
Key Points in the Treatment of Different Recovery Stages of Stroke
Stroke includes ischemic stroke and hemorrhagic stroke, namely cerebral infarction and cerebral hemorrhage. Their treatments are generally opposite. If it is a cerebral infarction, thrombolytic therapy is needed within 4.5 hours of the acute phase. It is necessary to consider whether there are indications and contraindications, and whether the patient and family members agree to undergo thrombolytic therapy. Regardless of whether thrombolytic therapy is administered, it is essential to subsequently check the condition of the cranial vessels to determine if surgical treatment is needed. If surgery is not required, hospitalization for conservative treatment might be necessary. Typically, about 7 to 14 days after the acute phase, rehabilitation treatment may be needed once the patient's condition stabilizes. The duration of rehabilitation treatment usually depends on the patient's recovery progress. Afterwards, it is important to consider the patient's underlying diseases, such as hypertension, diabetes, and other risk factors, to perform secondary prevention, which involves medication and control of risk factors. In the case of cerebral hemorrhage, the treatment during the acute phase depends on the amount and location of the bleeding and whether there are indications for surgery to determine if surgical treatment is necessary. If conservative treatment is chosen, it also involves hospital treatment, followed by possible rehabilitation treatment once stabilized.
Cerebral infarction X-ray manifestations
Brain infarction generally does not involve X-rays because X-rays primarily target bone issues, not brain tissue issues. If a brain infarction occurs, a cranial CT or MRI can be performed. In acute cases of sudden onset, a cranial CT is primarily used to exclude cerebral hemorrhage, as brain infarction typically does not show up in the acute phase. However, in cases of extensive brain infarction, changes might also appear on a CT during the acute phase. Additionally, after the acute phase, about 1 day or 24 hours later, brain infarctions generally appear as low-density shadows on a CT. On an MRI, in diffusion imaging, brain infarctions generally appear as high-density, high-signal areas, while they appear as low-signal areas in T1 imaging and high-signal areas in T2 imaging. It is also suggested to perform cranial magnetic resonance angiography to examine the status of the blood vessels.
Common clinical manifestations of stroke
Stroke includes ischemic stroke and hemorrhagic stroke, also known as cerebral infarction and cerebral hemorrhage. The clinical manifestations of cerebral infarction depend on the location of the occlusion, and may vary accordingly. Common symptoms include slurred speech and limb weakness. It generally occurs acutely, and may also include memory decline or a series of other symptoms depending on the specific location of the occlusion. If these symptoms occur, it is crucial to seek medical attention immediately, as there is an opportunity for thrombolytic treatment within 4.5 hours. In the case of cerebral hemorrhage, patients may experience symptoms during physical activity, possibly accompanied by severe headaches, as well as symptoms of neurological deficits such as unclear speech, limb weakness, or other symptoms. Seizures may also occur. It is essential to visit the hospital immediately if these symptoms appear. If cerebral hemorrhage is confirmed, the decision for surgical treatment depends on the amount of bleeding.
What should be paid attention to for facial neuritis?
Patients with facial neuritis usually have an acute onset, with facial nerve paralysis peaking within hours or days. It mainly manifests as paralysis of the facial expression muscles, disappearance of forehead lines, inability to frown, and incomplete closure of the eyelids. Therefore, patients with facial neuritis should pay attention to eye protection since the eyelids cannot close fully. Long-term exposure and drying of the cornea make it susceptible to infection. Therefore, it is necessary to wear an eye patch for protection or use some medicinal solutions to prevent infection and protect the cornea. Additionally, since there is a viral infection, patients should also avoid being chilled. In terms of diet, it is advisable to eat light food and avoid greasy, overly rich, or excessively spicy foods.
Myasthenia gravis initial symptoms
Myasthenia gravis is characterized by fluctuating and fatigue-prone muscle weakness in certain specific striated muscles. Symptoms are generally milder in the morning and more severe in the evening, worsening with continued activity and alleviating after rest. The most common initial symptom is weakness of the external eye muscles, primarily presenting as asymmetrical ptosis (drooping of the upper eyelid) or narrowing of the eye slit, along with diplopia, which refers to seeing double images. These are the most frequent initial symptoms, seen in over 50% of patients with myasthenia gravis. Additionally, some patients may experience disturbances in eye movement, facial muscle weakness, air leakage when puffing cheeks, incomplete eyelid closure, shallower nasolabial folds, as well as difficulty swallowing, speech articulation issues, choking while drinking, and potentially severe respiratory weakness.
Can lacunar infarction be treated?
Lacunar stroke is a type of cerebral infarction. It occurs due to long-term hypertension or other causes leading to arteriosclerosis in the small vessels inside the skull or other thrombus formations, leading to stroke. It is treatable, and the treatment is generally the same as for other types of strokes. Early on, depending on the patient’s condition, thrombolytic treatment can be chosen if it is within 4.5 hours from onset. However, if the symptoms are mild, the benefits and risks should be weighed. Treatment may also include antiplatelet therapy to improve circulation, lipid-lowering, and plaque stabilization. It is also necessary to tailor treatment to the individual patient and to further investigate whether there is significant narrowing of the vessels to guide prognosis.
Can someone with lacunar infarct work?
In cases where a lacunar stroke is discovered, it might be because symptoms have appeared, prompting a check-up that identifies the lacunar stroke. Such situations require proactive treatment; it is necessary to go to the hospital to decide when the treatment should end, after which one can continue working. If, however, a lacunar stroke is found during a routine physical exam without any symptoms, it might have been present for a while without causing any symptoms. In this scenario, one can continue working. However, regardless of the situation, it is advisable to further investigate the blood vessels to check the overall status of the vasculature.
Is a stroke a cerebral infarction?
Stroke includes cerebral infarction. Stroke is divided into ischemic stroke and hemorrhagic stroke. Therefore, ischemic stroke is cerebral infarction, and hemorrhagic stroke is cerebral hemorrhage. Thus, one cannot say it is solely a cerebral infarction; it includes cerebral infarction. If symptoms of stroke appear, such as unclear speech or limb weakness, it might be either hemorrhagic or ischemic stroke. In such cases, it is crucial to seek medical attention immediately. For hemorrhagic stroke, one should visit the neurosurgery department, and for ischemic stroke, the neurology department is appropriate. Initially, a CT scan should be performed to make a clear diagnosis.
How is epilepsy treated?
Epilepsy treatment can be divided into the following aspects: First is etiological treatment. If epilepsy is caused by tumors or cerebrovascular diseases, surgical removal of the lesion can relieve epilepsy, but seizures often still occur, so medication must not be stopped. Secondly, pharmacological treatment is necessary for epilepsy induced by unclear causes or genetic metabolic diseases. Treatment involves taking and adjusting medications under medical guidance, based on different types of seizures and individual patient circumstances. Additionally, for some cases where the cause cannot be clearly identified and no epileptic foci are found, functional surgery can be performed for treatment.