Duroplasty Essay

During the physical exam, your father was conscious and alert but yet he was also disoriented and confused as to what day and year it was. Eldon also had no idea as to where he was. His blood pressure level was 160/80 mm Hg, which is high, but we closely monitored his levels. His temperature increased from 101.3° F during transport to 101.8° F during the exam. We found that there were no focal neurologic deficits, meaning that we did not find any deficiencies or diseases of the nervous system. Chest x-rays, urinalysis, and blood cultures were also negative as well. When the radiology technicians performed a Magnetic Resonance Imaging or MRI on Eldon, The MRI image showed that he had encephalitis. Encephalitis is an inflammatory condition of the brain. The condition is characterized by headache, fever, and nausea. Neurological disturbances can include seizures, personality change, restlessness, and disorientation. In some cases, a comatose state might occur. We also performed an electrocephalogram or EEG to record Eldon’s brain wave activity. Your father’s brain wave activity was normal for his age and showed no signs of abnormalities. The Doctor prescribed Eldon take Acyclovir, which is an antiviral agent for encephalitis. On the second

suffered from was called Encephalitis Lethargica (Saxon). A doctor was called in to treat the

Patient is a 50-year-old-year-old left-handed white male who presents with his wife for evaluation of multiple symptoms that have been present since an MVA in 02/2013. At that time, he was T. boned and his car was totaled. He has amnesia for the event and is unaware whether or not he hit his head. The airbag did deploy. Afterwards, he was confused and noted significant pain in his neck and upper back. Since then, he has had multiple symptoms. He does have involuntary twitching on the right, more than left, both hands, legs, and sometimes feet. He demonstrates one of these twitches and it looks like a focal myoclonic jerk of a limb. These occur on a daily basis. He also has problems with his left thumb and index finger locking up. When he is fatigued, especially when his neck gets tight, he has some problems with word finding, paraphasic errors, and syntax errors. He did see Anthony P. Knox,

Patient is a 58-year-old right-hand white male interviewed in the presence of his wife. He was previously seen by me last month for admission for the acute onset of vertigo with possible TIA or stroke as etiology. He stated that he awoke on 06/18/2015 in his usual state of health and then went to work and while there, he had the sudden onset of marked spinning vertigo. He was unable to walk straight, but denied any bilateral lower extremity weakness. He did have nausea and vomited several times. He initially denied any diplopia, visual field cut, blurred vision, facial asymmetry, facial or body sensory changes, dysarthria, or focal weakness. He continued to have marked vertigo in the emergency room,

Chiari Malformation (aka Arnold-Chiari Malformation) is the condition when brain tissue extends into the spinal canal. This occurs when part of the skull is unusually small or misshaped which later causes pressure on the brain and forcing it downwards. There are 3 types of Chiari malformations. Type I develops as the skull and brain are growing, type II and type III are congenital.

During this quarter Jose did not experience any serious injuries. He experienced a hospitalization with admitting diagnosis of Acute Seizure (prolonged postictal lethargy and AMS) form 1/20/18 to 1/23/18; during his hospital staying, he consulted with the neurologist whom ordered an EEG that showed abnormal electroencephalogram consistent with independent interictal activity in both hemispheres supporting the diagnosis of chronic epilepsy; Trileptal was discontinued, no changes Keppra, Lamictal or Topamax. Other studies/workup included a CT head w/o contrast that showed chronic ethmoid sinusitis, normal chest x-ray, elevated ammonia levels, and low potassium (corrected). Prior his hospitalization Jose consulted with neurology on 11/21/17 who recommended the initiation of Trileptal, CT head if not done within 2017, and indicated that he may need a VNS if not improvement on refractory seizures. His next neurology follow up will be on 2/21/18.

According to the site Chiari Malformation, “Chiari Malformation is a structured defect in the brain and spinal cord. This happens sometimes during fetal development and is called congenital Chiari Malformation”(Chiari Malformation). Some Chiari can occur later in life when excessive amount of cerebrospinal fluid is drained away due to injury infection and exposure to toxic substances(Chiari Malformation). This is called secondary Chiari Malformation(Tamiz 1). He also said “Chiari is caused by poor diet. The indented bony space at the back of the skull is abnormally small. As results this will build up pressure on the

Patient is a 34-year-old left-handed white male who states that in January he was in a parking lot and was hit by a plow truck that was backing up. His back was turned and he did not know what was happening. He fell on his back and hit the back of his head on the tailgate. He denied any loss of consciousness. He did have a significant headache and neck pain, but no neurological symptoms. He did have some pain in his right hand and right ankle after this. He did present to the emergency room, where an unenhanced CAT scan was negative. Since then however, he has been having daily headaches. He has an almost constant, dull, mild bitemporal pressure sensation, but he also has significant

The patient denies having any history of CNS infection or already significant systemic infections. He has never had any thunderclap headaches, or any left-sided neurological symptoms. He does recall having a marked headache during the flight in the 1980s and one recent exertion-induced headache last fall, lasting 15 minutes. Otherwise, he gets mild headaches and aches and pains for which he does occasionally take aspirin. There is no family history of aneurysms. His father did die of a brain tumor, which the patient called the primary "Astro something". It was not metastatic. The patient says his ENT is aware of the nasopharyngeal mass and has called it polyps. The patient also has history of bradycardia and occasionally when he takes his pulse and he finds that it is irregular. He has an evaluation with a cardiologist coming up to rule out atrial fibrillation. He also has a family history of what may be a benign essential tremor. His father a couple of paternal uncles had this tremor. He has had it for years. It has slowly increased over the years, but it still is intermittent to high frequency, low amplitude, mostly action

When I was younger, I would get frequent headaches, which felt like knives going through my skull to say the least. As I got progressively older, the symptoms would get worse until even the slightest inconvenience, such as coughing, would render me paralyzed for several minutes because of the immense pain felt at the back of my head. In May 2013, I would finally be diagnosed with Chiari Malformation. Chiari, in simple terms, is a brain disorder in which the brain is too large for the skull, so the brain hangs over into the spine. This causes

Chiari malformation is defined as a series of malformations of the cerebellum and the skull. This is the result of many things, one is theorized to be premature births of infants.There are many other possible causes for this.Another is Hydrocephalus, or “water on the brain”, which is in reality an excess of cerebrospinal fluid, CSF around the skull. The history of this dates back to 1891, an Austrian pathologists by the name of Hans Chiari found a malformation of the brain. Doctor Chiari found the types I,III,and IV. He characterized the definition of the disorder as “ A series of malformations of the cerebellum/hindbrain and skull”. Years later, one of Chiari’s students Julius Arnold, expanded on the ideas Chiari had found. Chiari is named for both Hans Chiari and Julius Arnold.

The patient’s physical examination upon admittance (11/30/14) revealed the patient awake, alert and orientated x3; she was in some apparent distress but was not found to be in any pain. Auscultation of the lungs conceded adequate air entry bilaterally with bilateral rhonchi. The lower extremities showed pedal edema but with no signs of a deep vein thrombosis in the legs. Examination of the head, eyes, ears, nose and throat (HEENT) showed pink and moist oral mucosa. The pupils were equal and reactive to light.

However, there is no abnormal cord signal.There is a moderate to severe multilevel bilateral neural foraminal stenosis, predominantly due to uncovertebral joint degeneration, most severe on the right at C6-7. Cervical kyphosis and mild cervicothoracic dextroscoliosis are seen. Multilevel degenerative disc disease is noted, most significant at C4-5.

Other unusual complications include Guillain Barr’e Syndrome ,encephalitis, aseptic meningitis, transverse myelitis, cranial and peripheral nerve palsies6 .

The history of Chiari goes back all the way to the 17th century. That’s when reports were first published of hindbrain herniation. Hindbrain herniation had only been seen in the presence of patients with myelomeningoceles. According to The Chiari Malformations, Hindbrain herniation was found alone in 1881 by Langhans. 10 years