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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 the cause of swollen feet after a stroke?
Patients with cerebral infarction presenting with swollen feet and lower limb edema should be aware of the following reasons. The first scenario is due to reduced activity in the limbs on the paralyzed side, which results in weaker muscle contraction. Consequently, a large amount of blood accumulates in the lower limb veins, causing poor circulation and naturally leading to swollen feet. Therefore, it is crucial for patients to begin early rehabilitation training, engage in muscle massage, and perform passive joint exercises, among other activities. The second scenario that requires close attention is the formation of venous thrombosis in the lower limbs on the paralyzed side after a cerebral infarction. This condition can easily lead to venous thrombosis, which significantly contributes to foot swelling. Furthermore, it increases the risk of pulmonary embolism. It is important to complete routine coagulation tests and d-dimer examinations, as well as comprehensive lower limb venous Doppler ultrasound assessments.
Late-stage symptoms of senile dementia
Elderly dementia generally refers to Alzheimer's disease. This disease begins slowly and progressively worsens, with symptoms becoming increasingly severe. In the later stages of dementia, symptoms are numerous, mainly reflected in the following aspects: First, patients may exhibit significant personality changes. For example, a person who was originally gentle may become irritable and prone to aggressive behaviors such as hitting or yelling at others, and may even experience incontinence. Second, a patient's overall cognitive functions completely collapse, with a comprehensive decline in memory, as well as significant impairments in computational abilities, judgment, and comprehension. There are also problems with time orientation, with patients unable to distinguish between day and night. Additionally, patients may experience severe malnutrition, develop bedsores, and suffer from serious complications such as pulmonary infections and urinary tract infections.
Does myasthenia gravis require hospitalization?
Myasthenia Gravis is a type of neuroimmune disease within the field of neurology which fundamentally stems from issues with the patient's own immune function. Whether hospitalization is necessary depends critically on the severity of the disease. If Myasthenia Gravis manifests only as ocular symptoms, such as ptosis and double vision, hospitalization is generally not necessary. It is important to take certain medications, primarily cholinesterase inhibitors and corticosteroids, but regular outpatient follow-ups are essential. However, if Myasthenia Gravis is generalized, with noticeable whole-body weakness, particularly if accompanied by swallowing difficulties and coughing while drinking, hospitalization is required. If a myasthenic crisis occurs, presenting with respiratory muscle weakness and breathing difficulties, hospitalization is certainly needed, and admission to the ICU might be necessary.
Does brainstem hemorrhage easily recur?
The main cause of brainstem hemorrhage is hypertension, which can lead to hyalinization in the arteries that supply the brainstem, and even the formation of small aneurysms. Under the impact of blood flow, these are prone to rupture, leading to hemorrhage in the brainstem. This is the primary mechanism of onset for brainstem hemorrhage. If the brainstem hemorrhage is caused by hypertension, maintaining good control of blood pressure and keeping it below the ideal level of 140-90 mmHg can prevent frequent recurrence, so there is no need for excessive worry, but it is crucial to monitor blood pressure regularly. Additionally, brainstem hemorrhages can also be caused by other reasons, such as cavernous hemangiomas or arteriovenous malformations. If brainstem hemorrhage is caused by these diseases, and the abnormal vessels are not surgically removed, recurrence is likely. Removing these abnormal vessels can greatly reduce the likelihood of recurrent brainstem hemorrhages.
What department should I go to for a cerebral embolism?
Brain embolism is a disease in the field of neurology, and one can consult a department of neurology for it. Patients with brain embolism often have a rapid onset, generally with a history of atrial fibrillation. Some thrombi attached to the heart dislodge into the cerebral arteries, causing brain embolism. Symptoms can rapidly develop, including limb paralysis and speech disorders. If the affected area in the brain is large, it may even lead to consciousness disorders and epileptic seizures. For the treatment of brain embolism, interventional thrombectomy can be performed, but there is a strict limitation on the timing window. It should be noted that patients with brain embolism have a high probability of transforming into cerebral hemorrhage, and caution must be exercised during treatment.
Nursing Care of Thrombolytic Therapy for Stroke
Thrombolytic therapy for stroke is an important tool in the treatment of cerebral thrombosis. If administered within the thrombolytic time window, which is currently within four and a half hours from onset, intravenous thrombolytic treatment can significantly save lives and improve the quality of life for patients. Post-thrombolysis care is also crucial, as there are some complications associated with thrombolytic therapy. It is essential to strictly monitor blood pressure after thrombolysis; typically, blood pressure should be checked every 15 minutes, as high blood pressure can significantly increase the tendency for bleeding. During the care process, it is also important to monitor for signs of bleeding such as nosebleeds, bleeding gums, the appearance of petechiae or ecchymosis on the skin and mucous membranes, and any bleeding in the urinary system. Additionally, changes in the patient’s consciousness and limb mobility should be noted. If the patient experiences worsening paralysis or significant headaches, a cranial CT scan must be promptly revisited. In summary, the nursing care following stroke thrombolytic treatment primarily involves monitoring blood pressure, watching for signs of bleeding, and observing changes in limb mobility and consciousness.
Can stroke paralysis be cured?
For a disease like stroke, if paralysis occurs, a small portion of patients can be completely cured without any sequelae. These patients generally are younger in age, receive timely treatment, and do not have a particularly large area of cerebral infarction. However, for the majority of patients, some degree of sequelae is likely to remain. After a stroke, it is crucial to go to the hospital as quickly as possible. If thrombolytic treatment can be administered during the intravenous thrombolysis time window, it can be very effective, and a few patients may even be completely cured. For most patients, further treatment with antiplatelet therapy and rehabilitation training is needed. Although symptoms can significantly improve, complete recovery is relatively difficult.
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.