Natural Cure For Hydrocephalus In British Columbia

Case Study 17-1: Pediatric Brain Tumor

B.C., a 6-year-old first-grade student, was referred to a pediatric neurologist by his primary pediatrician for a neuro consult. He had presented with an acute onset of headaches, vomiting on waking in the morning, and progressive ataxia. The neurologist conducted a thorough neuro exam and ordered a CT scan, MRI, and lumbar puncture (LP) to look for possible tumor cells. When the LP revealed suspicious cells and the scans showed a tissue density, he was referred to a neurosurgeon for treatment of a suspected infratentorial astrocytoma of the posterior fossa.

B.C. had a craniotomy with tumor resection 5 days later. The cerebellar tumor was found to be noninfiltrating and was enclosed within a cyst, which was totally removed. B.C. spent 2 days in the neurological intensive care unit (NICU) because he was on seizure precautions and monitoring for increased intracranial pressure (ICP). A regimen of focal radiation followed after recovery from surgery. His spine was also treated because of the potential spread of tumor cells in the CSF. B.C. did not have chemotherapy because of the danger that he might develop hydrocephalus, which generally requires a ventricu-loperitoneal (VP) shunt.

B.C. was discharged 6 days after his surgery with a mild hemiparesis, which was expected to resolve within the next few weeks. He was scheduled for 6 weeks of outpatient rehabilitation, and his prognosis was good.

Case Study 17-2: Cerebrovascular Accident (CVA)

A.R., a 62-year-old man, was admitted to the ER with right hemiplegia and aphasia. He had a history of hypertension and recent transient ischemic attacks (TIAs), yet was in good health when he experienced a sudden onset of right-sided weakness. He arrived in the ER via ambulance within 15 minutes of onset and was received by a member of the hospital's stroke team. He had a rapid general assessment and neuro exam, including a Glasgow coma scale (GCS) rating, to determine his candidacy for fibrinolytic therapy.

He was sent for a noncontrast CT scan to look for evidence of hemorrhagic or ischemic stroke, post-cardiac arrest ischemia, hypertensive encephalopathy, craniocerebral or cervical trauma, meningitis, encephalitis, brain abscess, tumor, and subdural or epidural hematoma. The CT scan, read by the radiologist, did not show intracerebral or subarachnoid hemorrhage. A.R. was diagnosed with probable acute ischemic stroke within 1 hour of onset of symptoms and cleared as a candidate for immediate fibrinolytic treatment.

He was admitted to the NICU for 48-hour observation to monitor his neuro status and vital signs. He was discharged after 3 days with a prognosis of full recovery.

Case Study 17-3: Neuroleptic Malignant Syndrome

J.N., a 21-year-old woman with chronic paranoid schizophrenia, was admitted to the hospital with a diagnosis of pneumonia. She was brought to the ER by her mother, who said J.N. had been very lethargic, had a fever of 104°F, and had had muscular rigidity for 3 days. She took Haldol (haloperidol) and Cogentin (benztropine mesylate). Her mother stated that J.N.'s neuroleptic medication had been changed the week before by her psychiatrist. Her secondary diagnosis was stated as neuroleptic malignant syndrome, a rare and life-threatening disorder associated with the use of antipsychotic medications.

Case Studies, continued

This drug-induced condition is usually characterized by alterations in mental status, temperature regulation, and autonomic and extrapyramidal functions.

J.N. was monitored for potential hypotension, tachycardia, diaphoresis, dyspnea, dysphagia, and changes in her level of consciousness (LOC). Her medications were discontinued, she was hydrated with IV fluids, and her body temperature was monitored for fluctuations. She was treated with Bromocriptine, a dopamine antagonist, and Dantrolene, a muscle relaxant and anti-spasmodic.

After 5 days, J.N. was transferred to a mental health facility and restarted on low-dose neuroleptics. She was monitored to prevent a recurrence. Both J.N. and her family were educated about neuroleptic malignant syndrome in preparation for her discharge back home in 2 weeks.

CASE STUDY QUESTIONS

Multiple choice: Select the best answer and write the letter of your choice to the left of each number.

_ 1. A neurologist is a physician who:

a. performs brain surgery b. practices psychiatry c. practices psychology d. treats with natural and herbal medicine e. treats disorders of the nervous system

_ 2. A diagnostic procedure in which fluid is withdrawn from the spinal subarachnoid space is a(n):

a. thoracentesis b. lumbar puncture c. ventriculogram d. intracranial window e. trephine

_ 3. B.C.'s tumor was in the cerebellum, which controls voluntary movement, balance, and coordination. His motor dysfunction is called:

a. ataxia b. neurolepsis c. dysphagia d. dyspnea e. seizure

_ 4. A VP shunt is a surgical treatment for hydrocephalus. Excess CSF is shunted (drained) from the_by way of tubing tunneled to the_cavity.

a. vortex, ventricular b. ventricles, peritoneal c. peritoneum, ventricular d. ventricles, thoracic e. midbrain, stomach

Case Studies, continued

_ 5. Ischemic stroke is generally caused by:

a. hemorrhage b. hematoma c. thrombosis d. hemiparesis e. hemangioma

_ 6. Fibrinolytic therapy is directed toward the treatment of a blood clot in an artery by

_the_of the clot.

a. stabilizing, blood cells b. lysing, RBCs c. leaking, plasma d. dissolving, CSF

e. dissolving, fibrin matrix

_ 7. A general term for any disorder or alteration of brain tissue is:

a. cerebrocyst b. encephalopathy c. neurocytoma d. dysencephaloma e. psychosomatic

_ 8. J.N. had disease manifestations related to involuntary functions and to movement controlled by motor fibers outside the pyramidal tracts. These functions are:

a. antispasmodic and voluntary b. autonomic and neuroleptic c. autonomic and voluntary d. extrapyramidal and pyramidal e. autonomic and extrapyramidal

Write a term from the case studies with each of the following meanings:

9. tumor of astrocytes _

10. surgical opening into the skull _

11. sudden attack typical of epilepsy _

12. partial paralysis on one side _

13. inability to speak or understand speech _

14. inflammation of the meninges _

15. collection of blood below the dura mater _

16. perceived feeling of threat or harm _

drug that relieves muscle spasms

Case Studies, continued

18. antipsychotic medications

19. a physician who treats psychiatric disorders Define each of the following abbreviations:

27. LOC

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Responses

  • noemi lo duca
    Is there a natural cure for hydrocephalus?
    6 years ago

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