Dizziness Treatment: Insights on Neck Vascular Issues

Q: Dizziness Treatment: Insights on Neck Vascular Issues

Hello： General X-rays cannot determine if there is a rupture in the neck vessels. <br>It seems you may have misunderstood the doctor's explanation. <br>A rupture in the neck vessels is a very serious condition and cannot be an old injury. <br>If you have any questions, please vis

Treatment for dizziness depends on the underlying cause. Common approaches include: 1. Vestibular Rehabilitation Therapy (VRT): This is a specialized form of

Dear Dr.
Chiu,
My spouse, who is 58 years old, has been experiencing the following symptoms for over a month: dizziness, stiffness in the shoulders and neck, and fluctuating blood pressure.
The blood pressure readings over several measurements have been approximately: systolic 130-150 mmHg and diastolic 90-105 mmHg.
Two weeks ago, she visited a clinic in the northern region, where the physician reviewed X-rays and determined that three cervical blood vessels were severed, likely due to an old injury.
The doctor prescribed anti-anxiety medication and anti-inflammatory, anti-rheumatic, and peripheral nerve treatment medications.
After one week of treatment with no improvement, a follow-up appointment resulted in another week of the same medications.
Additionally, my wife had a fall several years ago, which has led to intermittent dizziness and elevated blood pressure, along with headaches when she overexerts herself mentally.
A family medicine physician assessed her condition as related to menopause and prescribed hormones and progesterone, which have largely resolved the dizziness and high blood pressure issues.
Recently, due to the stress of caring for our grandchild and lack of sleep, her condition has worsened.
I would like to ask Dr.
Liao if medication alone can heal the severed blood vessels.
If surgery is necessary, what is the success rate? How many days would it typically take from surgery to discharge?
I appreciate your response to these questions.
Thank you, and best wishes to you and your family.
Sincerely,
Zhang Jianzuo
October 10, 2005

A-Zuo, 60~69 year old female. Ask Date: 2005/10/10

Dr. Qiu Yushu reply Neurosurgery

Hello: General X-rays cannot determine if there is a rupture in the neck vessels.
It seems you may have misunderstood the doctor's explanation.
A rupture in the neck vessels is a very serious condition and cannot be an old injury.
If you have any questions, please visit the outpatient clinic for a clearer understanding of your condition.
Wishing you good health!

Reply Date: 2005/10/10

More Info

Dizziness and neck vascular issues can be complex and multifaceted, especially in a patient with a history of neck injuries and fluctuating blood pressure. Based on the symptoms described, including dizziness, neck stiffness, and variable blood pressure readings, it is crucial to consider both the vascular and neurological aspects of the condition.

Firstly, the diagnosis of "three broken neck vessels" is somewhat ambiguous. It is essential to clarify whether this refers to a vascular injury, such as a dissection or occlusion of the carotid or vertebral arteries, or if it pertains to a more general neck injury affecting the vascular structures. Vascular injuries can lead to significant complications, including stroke, transient ischemic attacks (TIAs), or chronic pain syndromes.

In terms of treatment, medication alone may not be sufficient if there is a significant vascular injury. The prescribed medications, including anti-anxiety and anti-inflammatory drugs, can help manage symptoms but do not address the underlying vascular issues. If there is a confirmed vascular injury, surgical intervention may be necessary, especially if there is a risk of stroke or if conservative management fails to alleviate symptoms.

The success rate of surgical intervention depends on various factors, including the specific type of vascular injury, the patient's overall health, and the presence of any comorbid conditions. Generally, vascular surgeries, such as carotid endarterectomy or stenting, have high success rates, often exceeding 90% for symptomatic patients. However, the risks associated with surgery must be carefully weighed against the potential benefits.

Post-operative recovery can vary significantly based on the complexity of the surgery and the patient's overall health. Typically, a patient may expect to stay in the hospital for a few days to a week, depending on their recovery progress and any complications that may arise. During this time, monitoring for neurological deficits, blood pressure stabilization, and pain management will be crucial.

In addition to surgical considerations, it is essential to address lifestyle factors that may contribute to the patient's symptoms. Stress management, adequate sleep, and physical therapy for neck stiffness can play a vital role in recovery. Given the patient's recent increase in stress due to caregiving responsibilities, it may be beneficial to explore support systems or counseling to help manage stress levels.

Furthermore, it is important to monitor blood pressure closely, as fluctuations can exacerbate dizziness and other symptoms. A comprehensive approach that includes regular follow-ups with healthcare providers, possible imaging studies to assess vascular integrity, and a multidisciplinary team involving neurologists, vascular surgeons, and physical therapists will be beneficial.

In conclusion, while medication can provide symptomatic relief, it is crucial to evaluate the need for surgical intervention based on the specific vascular injury. The success of surgery is generally high, but careful consideration of the risks and benefits is essential. A holistic approach that includes lifestyle modifications and stress management will also support recovery and improve the patient's quality of life. It is advisable to maintain open communication with healthcare providers to ensure that all aspects of the patient's health are being addressed.

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