Bulging Discs in Lumbar Spine

Bulging Discs

Bulging discs are very common and usually dont have symptoms until they become serious. A bulging disc is when the nucleus pulpus remains enclosed in the annulus pulposus. It is not very serious at this stage. Bulging is usually caused by spinal spurs pushing out on the disc and collapsed space between the vertebrae. A bulging disc only becomes a problem when the disc bulges out and presses up against nerves of the spine causing pain.

Symptoms of bulging discs depend on where the bulge takes place. The patient could have pain in the arms , legs, feet, and any region where the nerve is controlling. Bulging discs can also rupture which means that the jelly like substance which is the nucleus pulpus can leak out from the disc space causing pain and pressure.

A MRI or a CT is performed to help diagnose a Bulging disc in the spine. A MRI would be the selected choice for the lower back though. Treatment for this type of disorder is usually conservative treatment at first dealing with epidural steroid injections and physical therapy so that the body can absorb the disc herination. If relief is not achieved then surgery will then be suggested, for the herniation.

Carotid Body Tumor

Carotid Body Tumor

The two carotid arteries supply blood to the front part of the brain. The frontal lobe of the brain where thinking, speech, personality, sensory and motor function are at in the brain. If theses areas cannot recieve enough blood supply this can become an issue. One of the reasons for lack of blood supply can be a Carotid Body Tumor.


What is a Carotid Body Tumor?

These tumors are also called a Chemodectoma or a paraganlioma. These tumor can be small or big. They are found ni the upper neck usually at the branching of the carotid artery. These tumors are abormalites or masses in the artery that coming out of the wall that can restrict blood flow to the brain.

Symptoms of Carotid body tumor?

There are usually not many symptoms of these tumor. They are usually discovered by a non tender neck mass, dyspahia symptoms, and hoarsness of the voice. These tumors are usually begnin but can be malignant and if not remove they can metastisize to other areas of the body. Not to mention obstructing blood flow to the brain. A vascular surgeon is usually consulted for some sort of treatment.



What is Recommended to do about a Carotid Body Tumor?

There are many forms of treatment for this type of tumor depending on what type of tumor it is. The vascular surgeon can do a transcatheter emoblization and surguca removal or resection of the tumor. Most of the treatment for these types of tumors is safe and the outcomes are usually very successful. There can be risks with the surgery just like any other surgery dealing with stroke and the nerve damage or dysfunction of a nerve if it is close to the area of interset. The benefits greatly outweigh the benefits and are worth the removal of the tumor. In some cases Radiation therapy may be needed or accompany the removal of the tumor if it is malignant.

Carcinoma of the Tongue

What is Tongue Cancer?

The tongue is generally used for swallowing, taste, chewing, and cleaning of the oral cavity.Tongue cancer is also known as, “squamous cell cancer of the tongue.” Up to 30% of patients with one primary head and neck tumor have second primary malignancies which are usually on the tongue or the lips of the oral cavity which is apart of the soft tissue neck. Crazy enough, 3% of these malignancies arise within the oral cavity. Tongue cancer is more common of all the forms of oral cavity cancers. Most of these cancers are uncommon before the age of 40.

Factors of tongue carcinoma

Cancers of the head, neck, and tongue are strongly associated with alcohol, tobacco smoking, and tobacco chewing. Tobacco use has been linked to about 80% of all squamous carcinoma cases of the tongue, head, and neck. Smokers are 25 times more likely to develop oral cancer than non-smokers. Although if a patient were to quit smoking and chewing there chances of getting carcinoma will decrease gradually. Places where the betel nut is chewed have high incidence of cancers of the tongue and mouth. Cancer of the lips is also more prevalent with excessive sun exposure.
Tumors can look like sores on the tongue or big massive irregular tissue on the tongue. These tumors spread by local extension and through the destruction of different tissues such as: lymph nodes, cervical soft tissue, and oral cavity tissues.

How to Diagnosis Tongue Cancer?

Early diagnosis is the key to recovering and not dealing with great loss and side effects of this deadly disease. The earlier the tumor is found the more likely it can be removed and treatment can restore full function and normality. The longer a patient waits to seek treatment of tongue cancer the more likely it is for the cancer to be metastatic. Most tumors are usually found on the base of the tongue. These are the worst tumors to find because they are diagnosed at later stages usually on the tongue, which in turn means they are more likely to be deadly or have a not so good outcome which could involve losing parts of the tongue. Other than visibly looking at the tongue and any abnormalities on the tongue, it is important for other tests to be conducted. Another way for diagnosis is by running tests on blood and enzyme levels of the body. Abnormal liver function tests can also help verify cancer. Although in early investigations of tongue cancer some tests can come back normal.

Symptoms of Tongue Cancer

1.Red and white patches on the tongue, gums, and the lining of the mouth

2.Difficulty or pain in chewing or swallowing

3.Abnormal painful lump or bump on the tongue

4.Sore throat that does not go away

5.Pain in the ear

6.Change of voice

7.Unusual bleeding

8.Numbness in the mouth

How to treat carcinoma of the tongue

After the cancer has been diagnosed and staged for the patient then a proper treatment plan can be executed. Most lesions care biopsied, and then treated depending on how far along the cancer is. Most likely localized lesions that have not spread go through curative surgery to remove the lesions and/or radiation. Large lesions that can compromise speech and the ability to talk are usually treated with radiotherapy. All other advanced cases of this cancer that has or potentially spread are aggressively treated with radiation therapy and chemotherapy. If the cancer is diagnosed early the survival rate is extremely high.

Basically to prevent yourself from having tongue cancer you must reduce your risk factors… so you should quit smoking ( JUSTIN)… not chew tobacco, and not excessively drink because these habits all factor in to oral cancer in the mouth.

Sacular Aneursyms

Sacular Aneurysm

A Sacular aneurysm can also be called an intracranial berry aneurysm. This aneurysm consists of a saclike “out pouching” in a cerebral blood vessel. 1 in a 1000 people a year has an incidence of these types of aneurysms. This type of aneurysm can be very dangerous and are very likely to rupture and cause a stroke. These types of aneurysms should not be take lightly and are very dangerous. These types of aneurysms have a 70-90% mortality rate.

Sacular aneurysms occur when there is weakening of the blood vessel wall in the cerebrum. This weakening can start to bulge out because of increase blood pressure forming an aneurysm within the blood vessel. The circle of Willis is very susceptible to secular aneurysms because of the small vessels that lead to larger vessels in the brain. Other typical sites that these aneurysms can occur are the vertebral artery and the basilar artery.

Risk Factors of Sacular Aneurysms

Conditions that can cause secular aneurysms include: hypertension, renal disease, conditions causing weakening of blood vessels, genetic disorders, and head trauma. There can be many complications that deal with secular aneurysms, if an aneurysm ruptures then the patient can be at risk for stroke, vasospasm, and a subarachnoid hemorrhage.

Signs and Symptoms

1. Headaches
2. double vision
3. loss of vision
4. eyes and neck pain

Symptoms of a ruptured aneurysm include :

1. A sudden sever headache
2. confusion
3. seizures
4. eyelids drooping
5. fatigue
6. confusion
7. Sudden mood swings

Diagnosis and Treatment

These types of aneurysms can be diagnosed by CT, MRI, angiography, and cerebrospinal fluid analysis. If aneurysms are discovered and have not yet ruptured most of the time the patient is taken to surgery and they can have a Micro Vascular clip put in. When the clip is put in, the blood flow is cut off to the aneurysm and it usually does not return. This treatment is known to be highly effective. Another procedure they can use is called an Occulsion. An occlusion is when the entire artery that is involved with the aneurysm is clamped off and the blood supply is rerouted away from the artery with the aneurysm. If a patient is diagnosed it is very important for them to control there blood pressure, not smoke, and avoid cocaine and other drugs that can elevate blood pressure which could eventually rupture the aneurysm.

Blowout Fractures

Blow-Out Fractures of the Orbit

Blow out fractures are caused by direct trauma to the eye. When there is trauma to the eye from being hit by a fist or a ball larger than the orbit, an increase in pressure within the orbit can occur. A blowout fracture by definition is, “a break in one of the thinner orbit bones and the possibility of the nerves and eye muscles in the orbit are being pushed through the break in the orbit.” The orbit rim basically buckles which results in an orbital floor fracture.

Symptoms

When trauma to the orbit is caused, blood vessels can become broken in the eye and the blood will rush to the eye and tissues surrounding the eye causing a black eye. Another symptom of a blow out fracture is when the swelling goes down the eye can look sunken in the orbital bones. Double vision can occur in the eye that was inflicted by the trauma. Sometimes the upper back teeth of the effected side and cheek can become numb as well. Not to often nausea can occur right after the injury has been sustained. When the patient is being examined in for facial/orbit trauma, the orbits will be examined along with the pupil size and the patient’s vision. Sometimes the orbit can become so swollen that an examination cannot be performed and the doctor will have to wait to reassess the orbit.

Treatment

Treatment for blowout fractures depends on how severe the damage is to the orbit. The orbits will be assessed by either: CT images, diagnostic, and sometimes MRI. The main injury in blowout fractures has to do with the orbital bone. If the damage is not extensive it can be left alone to heal without any type of treatment. If the patient is experiencing dilated pupils, double vision, and/or a sunken eyeball surgery could be required. If surgery is required the orbit will be repaired by sealing the hole in the orbit bones by a thin plastic implant. The good thing is if surgery is required the surgery can be postponed for up to two weeks and scarring is little to none with not a long recovery time. Most of the time surgery can be a permanent cure the only side effects are that double vision and the eye being sunken in can come back rarely does that happen, but it is possible. This condition is very treatable.

Retinoblastoma

Retinoblastoma

Retinoblastoma, is a rare malignant tumor of the retina of the eye. This diesease is usually found in young children that are usually around 1-2 years of age. It can be found in children all the way up to usually 6 years old.

Causes

Retinoblastoma usually occurs when a cell in the retina becomes mutated. The retina cells then start to grow uncontrollably and the growth becomes cancerous. This cancerous tumor is usually hereditary and children who have a the gene in their families are 50% more likely to develop retinoblastoma. Symptoms of this disease include: whiteness of the pupil of the eye and a cancerous growth growing from the affected eye. The eye can lose sight and blindess will then occur in that eye. The eyes can appear crossed and if the tumor is left untreated it can spread to the optic nerve, eye socket, brain, lungs, and even bone.

Treatment

Treatment solely depends on the size of the tumor, location, and if it has spread or not. If the tumor is small it can be cured by laser surgery and if the tumor has spread then chemotherapy treatment will be needed to further cure the part to where the mutation had spread to. Almost all patients that have the tumor can be cured if the tumor has not spread past of the eye, depending on the severity of the tumor will depend if they whole eye must be removed. If the tumor has spread there is a lower survival rate, it all depends on how the tumor was spread. A patients best bet is to contact there healthcare provider if there are abormalities with the eyes and even if the eyes look abnormal in photographs. MRIs are usually obtained to help diagnose Retinoblastoma, T1 and T2 images are obtained in all 3 planes and the Axial is the most useful. Contrast will be administered to judge whether it is a tumor or not and also if the tumor has spread to different areas other than its orgin.

Prolactinoma

Prolactinoma

Prolactinoma is a noncancerous pituary gland tumor. This particular tumor tends to make the pituitary gland overproduce the hormone prolaction. Which is a sex hormone regular hence, estrogen for women and testosterone for men. This tumor is not usually life threatening and can be treated with medications or if they are having issues with visual impairent or infertility they can opt for surgery to have the tumor removed.

SYMPTOMS

Symptoms for Prolactinoma vary from person to person and definitely from male to female. In males the symptoms can range from: headaches, infertility, visual impairment, loss of sexual drive, high levels of sex hormones, erectile dysfunction, and uncommonly enlarged breasts. In females the symptoms can be: irregular menstral periods, milky white discharge from breasts when the female isn't pregnant, painful dry sexual intercourse, and low bone density.

There are other diseases besides Prolactinonma that can cause an overproduction of prolactin, such as : hypothyrodism, different medications (high blood pressure medicine,tranquilzers, and antinausea), other pituitary tumors, and pregnancy.
Prolactinomas are not common in children. Prolactinomas are occur more in women and men. Women are usually diagnosed at a younger age then men are.

MRI is used with and without contrast to help see the tumor in differnet planes. The contrast helps to isolate the tumor and will usually appear white in the images when contrast is administered.

Complications of Prolactinoma

Some complications of this disease can include: Vision loss is the tumor is not found it can press against the optic nerve. Osteoporosis , prolcation helps control estrogen which helps to regulate your bone density, and Pregnancy if a women is pregnant her pituitary usually produces more prolaction but, when a women has a prolactionma she can experience headaches, nausea vomiting and extreme fatigue because of the excess prolactin.

Meniere's Disease

Meniere's Disease

I chose Meinere's Disease because I have a friend's mother that actually was diagnosed with Meiere's Disease of the inner ear. Studies have shown that Meniere's disease is common in 200 out of 100,000 people, and usually occurs in people that are 40 years of age or older.

Meniere's inner ear disease is caused usually by, " Distention of the endolymphatic compartment of the inner ear." This dieseae strictly deals with the fluid flowing in the inner ear. It usually only happens in one of a patients ears. Why a person will suddenly have Meniere's diease is unknown. Sometimes Meniere's Disease will just suddenly appear and can be triggered from trauma or a fall. Symptoms of Meniere's Disease include: episodes of vertigo, feeling like the room is spinning, ringing in the ear, feeling like there is a pressure in the ear, and also hearing loss that will just come and go throughout the attack. MRI is used to have different pictures in different planes to help rule out different pathologies that could have the same symptoms as Menieres disease to help with a faster diagnosis, if the patient does have Meniere's disease.

TREATMENT

Treatment for Meniere's disease strictly depends on how bad a persons attack is and how bad there attacks are. The diesase is mostly commonly controlled through a patient's diet with limiting sodium and caffiene intake. Stress can trigger a Menieres diesase attack as well. If a person has a lot of pressure in there ear a Diuretic or water pill can be prescribed to help with the pressure. The Vertigo and Nausea are treated with Dramamine and Antivert. For drastic cases surgery can be performed to prevent further deteriortation of hearing loss. The decision to operate on the patient is purely up to the patient and there are risks of going deaf involved with Menieres Disease and if surgery is opted for as well. Smoking (JUSTIN) has been linked to the occurance of Meniere's disease, but some studies do not think that is a credible statement, but other studies that have been performed say that some patients when quitting smoking their attacks and symptoms were no longer there.

My friend's mother went to a specialist for her Meniere's Disease and they told her there wasn't a lot they could do with her, although she does drink a lot of caffiene and eats a lot of sodium and she has been trying to control her Meniere's disease with diet she has been trying to come up with some kind of cure without surery, so that she doesn't eventually lose her hearing for good. She said that deafness is what eventually will happen in that ear.

Medulloblastoma

Medulloblastoma

Axial view of head... with and without contrast.

I chose this disease because I had never heard of it before, and I figured it had to do with the Medulla oblongata and everyone seems to be obsessed with that word and its very fun to say!


What is Medulloblastoma?

Medulloblastoma is a disease that is usually malignant. It is one of the most common central nervous system tumors found during child hood. This highly malignant tumor can be found in the 4th ventricle in the brain. This ventricle is located in between the brain stem and the cerebellum. If this tumor is left untreated it is highly susceptible to spreading to the central nervous system and though not likely even to specific organs. The only way to determine that you could potentially have this disease is through an MRI and through a cerebral spinal fluid analysis to stage the cancer cells.


Symptoms of Medulloblastoma

The most commonly seen symptoms of this disease are: headaches, unsteadiness, high pressure within the brain, fatigue, and even vomiting. Vomiting is usually due to the blockage of cerebral spinal fluid flow to the brain. Because this type of tumor is ridiculously fast growing diagnosis is usually within the first 1-3 months of the patient starting to have the specific symptoms. In rare cases the patient could even be in a coma or appear in a great amount of distress do to bleeding within the tumor itself.

Sagittal T1 MRI image with contrast

Treatment

There are many treatments that are available now to help treat Medulloblastoma. The most common treatment methods are: VP shunt, surgery to remove the tumor, radiation, and chemotherapy. Although there are always risks involved in all three treatments, treatment options can be scary and very nerve racking. A ventriculoperitoneal shunt is used to help regulate CSF pressure within the brain. According to studies treatment has become a lot more effective and safer for this disease. Life expectancy is much more significant if the tumor is taken out and treated aggressively. Although with these treatment options there are great risks involved, such as loss of speech and balance difficulties. Many studies are being conducted for this disease, so far they have concluded that 8 out of 10 children that are treated aggressively with radiation, surgery, and chemotherapy are usually at some degree of being tumor free or cured after 5 years of extensive treatment, although they only have a 50% chance of staying disease free post treatment.

((Practice Blogster))

Soooo.. my name is Jamie my favorite color is pink ( obviously).... I work at Deaconess in the Emergency room. I love to travel, animals, and just life in general. I love music it's been a huge part of my life for a really long time. I also love to workout and enjoy being around all of my friends.. and I LOVE to make new ones too!! uhhh my Favorite things to do in class are:
1. TALK about Justins MOM (haha)
2. Laugh.. i LOVE to laugh
3. Drink diet Rockstar to stay awake
4. Listen to Brianne talk about "penile implants"

And I could totally list more but I need to go to bed to get up for clinicals in the morning!

funny stuff I know....