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Zhang Hui
Neurology
About me
Weifang People's Hospital, Department of Neurology, attending physician, has been engaged in clinical work in the field of neurology for many years, with rich clinical experience in common and prevalent neurological diseases.
Proficient in diseases
Cerebrovascular disease, Parkinson's disease, myelitis, etc.
Voices
What is needed to diagnose Parkinson's disease?
The definitive diagnosis of Parkinson's disease primarily relies on the patient's medical history, clinical manifestations, and a thorough physical examination by a neurologist. If the onset of the disease is very slow, presenting with symptoms such as bradykinesia and tremors, and the neurologist observes heightened muscle tone and slow movements during the examination, a high suspicion of this disease is warranted. Additionally, certain auxiliary tests are necessary, commonly including: First, testing the patient's sense of smell is crucial, as a reduced sense of smell is very important in diagnosing Parkinson's disease. Second, some brain MRI scans are needed mainly to exclude some secondary Parkinson's syndromes. Third, a brain PET-CT scan can be performed to examine the functionality of the striatum. Furthermore, an ultrasound of the substantia nigra in the midbrain can also be conducted, which holds significant value in assisting the diagnosis.
Post-stroke depression
Recent studies have confirmed that in addition to language dysfunction, cognitive impairment, and motor dysfunction, stroke patients also exhibit many signs of depression. According to guidelines published in China in 2016, about 33% of stroke patients experience post-stroke depression, which is a very high proportion. The main symptoms of post-stroke depression include a lack of interest in anything, unwillingness to communicate with others, being quiet and reticent, non-compliance with medication, and non-cooperation with rehabilitation training. Post-stroke depression significantly affects the recovery of patients and their future quality of life. Some patients may even turn to suicide due to depression. Therefore, it is crucial to pay attention to depression after a stroke, as the incidence rate of post-stroke depression is very high, reaching up to 33%. Clinicians must carefully identify it, and family members of patients must be attentive in their care.
What will happen with brainstem hemorrhage?
Brainstem hemorrhage is a very dangerous disease because the structure of the brainstem is so crucial. It contains the life centers responsible for breathing and heartbeat, as well as sensory and motor nerve fibers passing through it. If the brainstem hemorrhage is severe and the amount of bleeding is large, the patient may experience paralysis of the limbs, swallowing dysfunction, and choking on water, among other symptoms. If the condition worsens, it can lead to coma, persistent high fever, and even death. Patients with minor brainstem hemorrhages may exhibit symptoms such as dizziness, nausea, vomiting, numbness in the limbs, and paralysis. Generally, brainstem hemorrhages are caused by hypertension, which must be well controlled.
Pediatric Encephalitis Examination Items
Encephalitis in children is primarily due to a lowered immune resistance, which leads to infection by certain viruses. These viruses invade the nervous system, causing damage to neurons, resulting in symptoms such as fever, headache, nausea, and vomiting. Generally, the main tests for pediatric encephalitis include hematological tests related to bleeding, primarily involving routine blood tests, C-reactive protein, and erythrocyte sedimentation rate. These indices can reflect the inflammatory conditions inside the patient's body, helping to distinguish between viral and bacterial infections. Another very important auxiliary examination is the electroencephalogram (EEG), where pediatric encephalitis can show mild to moderate abnormalities, which is helpful for accurate diagnosis. The third examination involves performing a lumbar puncture to test the cerebrospinal fluid (CSF) for the levels of white cells, glucose, and chloride, which are crucial for diagnosing encephalitis and differentiating it from other types of encephalitis.
Can brainstem hemorrhage be treated abroad?
Patients with brainstem hemorrhage mostly have a risk factor of long-term hypertension, and they usually have poor blood pressure control. This results in small artery lesions, and under emotional excitement or severe fluctuations in blood pressure, bleeding in the brainstem occurs. Brainstem hemorrhage is quite dangerous; many patients who suffer from a significant amount of bleeding in the brainstem can fall into a coma, and some, even if their lives are saved, might end up with paralysis of the limbs or in a vegetative state. Currently, this is a global challenge, and brainstem hemorrhage is generally not advised to be treated surgically. However, some top experts both domestically and internationally have attempted surgical treatment for brainstem hemorrhage, and a portion of patients may see some effects from it, but generally speaking, most hospitals do not advocate for surgical treatment of brainstem hemorrhage. The treatment protocols for brainstem hemorrhage do not vary significantly between countries; the international treatment plans are quite similar.
What is good to eat for Parkinson's disease?
Patients with Parkinson's disease should pay special attention to their diet. It is recommended that the food eaten by Parkinson's patients mainly includes the following types: First, patients can eat more fresh cabbage, vegetables, celery, and fruits such as apples, oranges, bananas, and tangerines, because these fruits and vegetables help supplement some vitamins. Vitamins have an antioxidant stress effect, which may play a role in preventing the further development of Parkinson's disease. Additionally, these foods can supplement water, promote gastrointestinal motility, and alleviate constipation, which is beneficial for the constipation caused by Parkinson's disease. Second, people with Parkinson's disease can eat more walnuts or black sesame seeds, as well as some other nuts, as these foods also nourish brain cells. Moreover, patients with Parkinson's disease must ensure a balanced diet that includes a variety of grains, such as rice, millet, corn, and sorghum, which are all consumable.
Encephalitis belongs to which department?
Encephalitis is primarily a neurological disorder and is an infectious disease of the central nervous system, mainly diagnosed and treated in neurology. There are many causes of encephalitis, with viral encephalitis being the most common. For example, herpes simplex encephalitis is a typical type seen clinically. Patients may experience fever, even with very high temperatures exceeding 40°C, headaches, nausea, and vomiting. If the condition worsens, seizures, coma, and cognitive impairment may occur. These clinical manifestations require further investigations like electroencephalography, cranial MRI, and lumbar puncture. Additionally, there is a specific type of epidemic, known as Japanese encephalitis, which falls under the category of infectious diseases due to its contagious nature.
Symptoms of cerebral atrophy
Mild cerebral atrophy may not present any clinical symptoms, and many elderly people show some degree of cerebral atrophy during imaging examinations, which should not be overly worrying. If the cerebral atrophy is more pronounced, it mainly manifests as cognitive dysfunction, such as a decline in memory, reduced computational abilities, diminished executive functions, and possibly the inability to perform complex movements, such as being unable to brush one's teeth or dress oneself. In severe cases, individuals may experience personality changes, becoming irritable, easily angered, suspicious, and may even exhibit psychiatric symptoms, primarily hallucinations.
How long does it take to wake up from a brainstem hemorrhage?
Brainstem hemorrhage is a very serious condition. If the amount of bleeding in the brainstem increases, the patient will rapidly become comatose and exhibit symptoms such as paralysis of the limbs, inability to swallow, and inability to speak. Generally, if a patient with brainstem hemorrhage falls into a coma and cranial CT confirms a large amount of bleeding in the brainstem, the chances of the patient waking up are very, very slim. If the amount of brainstem hemorrhage is not particularly large and the patient's level of coma is not very deep, treatment may lead to the patient waking up, which could take about two to four weeks. However, the prognosis for brainstem hemorrhage is generally poor, and if the patient falls into a coma, they are usually unlikely to wake up. The treatment for brainstem hemorrhage mainly involves controlling blood pressure and preventing complications. If respiratory failure occurs, timely treatment with a ventilator is necessary. Overall, brainstem hemorrhage has a poor prognosis and high costs.
What tests are conducted for encephalitis?
First, it is generally necessary to conduct an EEG test. This test is very convenient and non-invasive for patients. If significant slow waves are detected, encephalitis cannot be ruled out. Secondly, an MRI of the brain should be performed. If the viral encephalitis is severe, abnormal signals can be observed in areas such as the frontal lobe, temporal lobe, and hippocampus on the MRI, which are of great diagnostic reference value. Thirdly, lumbar puncture is also very important. It allows for a direct observation of the color of the cerebrospinal fluid, to monitor the pressure of the brain fluid, and to test the cerebrospinal fluid for cell count, protein, sugar, and chloride levels. These tests are very important for the diagnosis and differential diagnosis of encephalitis.