Stroke, Neurology FAQ

Understanding Tiny Acute Ischemic Infarcts: Causes and Management

Physical examination revealed signs of a previous minor stroke? Hello Doctor: Last month, the MRI results for my brain were interpreted as follows: Z719 Counseling, unspecified, V6540 Counseling, not otherwise specified, ||cre:0, eGFRr:0 Imaging findings: Brain MRI study without ...

Dr. Jiang Junyi Reply:
Hello, sir: You mentioned "A tiny acute ischemic infarct, left occipital subcortical white." An elder relayed that it was a concussion; could this have related effects? MRI primarily detects cerebral infarctions within a month. It cannot explain events that occurred muc...

Dizziness After Exercise or Work: Understanding Your Symptoms

Dizziness or lightheadedness after exercise or work? Hello, recently I have been experiencing dizziness after intense exercise or during activities that involve holding my breath. I often feel dizzy when there is significant movement or shaking of my head and neck, especially aft...

Dr. Jiang Junyi Reply:
Hello Ms. Alex, You mentioned that you often feel dizzy after intense exercise or breath-holding activities, and after exertion (or standing up too quickly after bending down for a long time). This may indicate symptoms similar to syncope. When cerebral blood flow drops below 30...

Understanding Unexplained Tremors and Fatigue: When to Seek Help

Feeling extremely fatigued and on the verge of fainting, with involuntary body tremors? I would like to consult a doctor. Recently, I have been experiencing involuntary body tremors at night before sleep. I am unsure if this is due to excessive tension. My eyelids also twitch int...

Dr. Peng Shiwei Reply:
Hello, based on your symptoms, there are currently no specific findings and no neurological localization. Additionally, since the symptoms occur at specific times, the likelihood of a stroke is low. Furthermore, smoking is detrimental to your health, so please quit smoking immedi...

Managing Anticoagulants and PPI Use in Neurology Patients

Medication issues? Dear Doctor, I am currently taking anticoagulants (Pradaxa) twice daily due to a minor stroke. I am experiencing gastrointestinal discomfort and need to undergo an endoscopy. How long should I stop taking Pradaxa, and when can I resume it? Additionally, can I t...

Dr. Peng Shiwei Reply:
Hello, generally speaking, Prasugrel only needs to be discontinued for one day. However, if your kidney function is impaired, it may need to be stopped for 1.5 to 2 days. There is no specific interaction between Prasugrel and PPIs, so they can be used together.

Understanding Diplopia: Follow-Up Tests and Stroke Risk Management

Follow-up examinations for binocular diplopia? Hello Doctor: Recently, I experienced double vision after suddenly looking at certain objects, but my vision returned to normal afterward. I went to the hospital for an examination, and the ophthalmology report showed no issues. Howe...

Dr. Jiang Junyi Reply:
Hello Mr. Green Tea, You mentioned "normal blood sugar levels" in relation to cardiovascular disease risk factors. In addition to diabetes, other risk factors include hypertension, smoking, and hyperlipidemia. Prolonged exposure to these risk factors can lead to athero...

Postpartum Hand Tremors: Understanding Causes and Treatment Options

Postpartum tremors Hello Doctor: In mid-February of this year, I had a natural delivery without epidural anesthesia. About ten days after being discharged, I occasionally experienced tremors in my right thumb, which later progressed to my entire arm shaking. Before the tremors st...

Dr. Wu Mukhan Reply:
Your symptoms may indicate a movement disorder, and a personal evaluation by a physician is necessary for further assessment. It is recommended to visit a medical center where a neurologist with expertise in movement disorders can arrange for subsequent examinations and treatment...

Addressing Soft Palate Dysfunction After Stroke: Seeking Solutions

My dad's soft palate is not moving? Hello, Doctor. My father suffered a stroke affecting the left and right corona radiata, which has resulted in very unclear speech, significant nasal voice, excessive drooling, inability to elevate his tongue, and weakness in elevating the ...

Dr. Peng Shiwei Reply:
Hello, from a neurology perspective, both limb weakness and soft palate weakness can be caused by a stroke. Therefore, it is recommended to focus on rehabilitation. I am not sure if your father is undergoing speech therapy. Generally, the first 3 to 6 months after a stroke is con...

Understanding Your Neck Ultrasound Results: A Guide to Carotid Atherosclerosis

Neck ultrasound examination Hello, doctor. In 2020, I had a neck ultrasound examination, and the doctor said everything was normal, did not prescribe any medication, and did not mention the need for follow-up tests. However, I found on Google Translate that there might be issues ...

Dr. Jiang Junyi Reply:
Dear Ms. Heifetz, You mentioned, "Neck ultrasound report: Conclusion Mild carotid atherosclerosis without significant hemodynamic change." Essentially, this examination report indicates that the level of atherosclerosis is within the normal range. Common risk factors f...

Understanding Dizziness and Neck Issues: MRI Insights Without Contrast

Dizziness, cervical spine issues? Hello, Doctor. I would like to ask about the cervical spine MRI. If no contrast agent was injected, to what extent can vascular issues be identified? I have been experiencing neck tightness and stiffness for the past three months (which is why th...

Dr. Peng Shiwei Reply:
Hello, your issue is related to the settings of the MRI machine used during the examination and its resolution, so I cannot provide you with a definitive answer. However, considering your age, neck stiffness is mostly not directly related to the cervical blood vessels, unless you...

Can Daytime Sleepiness and Nighttime Delirium Improve in Parkinson's Patients?

Can daytime sleepiness and nighttime delirium in a patient with stage II Parkinson's disease be improved? Three months ago, my mother was diagnosed with stage II Parkinson's disease (due to multiple small strokes). Currently, she requires a walker for mobility and moves...

Dr. Peng Shiwei Reply:
Hello, I believe your mother's delirium symptoms are not related to the chronic course of Parkinson's disease, but are more likely associated with her previous infection and hospitalization. Generally, this type of acute delirium tends to improve gradually over time, an...

Understanding Finger Tingling: Causes and When to Seek Help

Numbness in the fingertips? Hello, doctor. For the past three days, I have been experiencing a sensation in the fingertips of both hands (more so in the right hand) that feels like there is a foreign object present, intermittently. Occasionally, I also feel a tingling sensation, ...

Dr. Jiang Junyi Reply:
Dear Mr. A-Jia, You mentioned that "sometimes there is, sometimes there isn't... occasionally feeling like an electric current flowing through the back of the hand and fingers," which may suggest a peripheral nerve issue. Common causes include sensory nerve abnorm...

Traveling by Plane After a Stroke: Safety Tips for Patients

Flying After a Stroke Hello Doctor, my father is 58 years old. He had a mild stroke in early November 2021 (at that time, he was unable to speak, had complete weakness in his limbs, and was unable to manage his bowel and bladder functions, so he could only lie in bed). He has sin...

Dr. Jiang Junyi Reply:
Dear Mr. Hua, You mentioned that your father "had a stroke in 2021... has been undergoing dialysis since 2018, and underwent coronary artery bypass surgery at the end of 2018." Generally, for stroke patients, it is recommended to wait at least 2-4 weeks after the strok...

Understanding Left-Sided Numbness: Possible Neurological Causes

Left-sided partial numbness? Hello, I have a situation that may seem strange, but I couldn't find similar reasons no matter how much I searched, so I'm reaching out to you. It started with an itch in a single tooth, and I initially thought it was a gum issue. However, t...

Dr. Wu Mukhan Reply:
Hello, it seems that you are experiencing sensory abnormalities on the left side of your face as well as on the left side of your body. This situation requires ruling out any issues related to the brain, as stroke or central nervous system lesions cannot be completely excluded. I...

Understanding Unilateral Numbness and Headaches: When to Seek Medical Help

Unilateral limb numbness and headache? Hello Dr. Wu, on March 18th around 5 PM, I suddenly experienced numbness in my right calf extending to the sole of my foot, which lasted until about 9 PM. After taking a hot shower, it slightly improved. At 10 PM, I then felt numbness in my ...

Dr. Wu Mukhan Reply:
Hello, if there is sudden unilateral numbness or weakness in the limbs, it is important to be cautious about potential cerebrovascular issues (such as a stroke). If the symptoms have resolved, it is advisable to visit a neurology outpatient clinic as soon as possible; however, if...

Sudden Numbness in One Side: Possible Causes and When to Seek Help

Unilateral limb numbness? At 5:30 PM, I suddenly experienced numbness in my right calf extending to the sole of my foot. After soaking it in hot water, it felt somewhat better. However, by 9:30 PM, I started to feel numbness on the outer side of my right palm and the outer side o...

Dr. Wu Mukhan Reply:
Hello, if there is sudden unilateral numbness or weakness in the limbs, it is important to be cautious about potential cerebrovascular issues (such as a stroke). If the symptoms have already resolved, it is advisable to visit a neurology outpatient clinic as soon as possible. How...

Understanding Pulsating Temples: Causes and Concerns After Head Injury

The temple is pulsating continuously? Hello, I am consulting on behalf of my mother. A few years ago, she was in a car accident where she hit the left side of her head, but there were no external injuries. Over the years, she has occasionally experienced headaches, but since the ...

Dr. Jiang Junyi Reply:
Dear Ms. Chen, You mentioned that your mother "often presses on the left temple..." which may indicate tension-type headache, caused by muscle tightness in the head. Common manifestations include tight, constricting pain in the forehead and temples, resembling the sens...

Neurological Issues in Left Body After Right Brain Surgery: Seeking Solutions

Abnormal nerve sensations on the left side of the body? Hello, doctor. A year ago, I underwent a craniotomy for a right brain surgery, which resulted in numbness on the left side of my body. I have diminished sensitivity to temperature and pain, and at times, I experience a burni...

Dr. Jiang Junyi Reply:
Hello Mr. Hu: You mentioned that "the left side of your body has a numb sensation, with unclear perception of hot and cold as well as pain. Sometimes there is a burning sensation from the calf to the sole of the foot. You have undergone acupuncture rehabilitation this year b...

Post-Ischemic Stroke Follow-Up: Understanding Risks and Medication Adjustments

Follow-up after ischemic stroke? Doctor, my mother had an ischemic stroke 4.5 years ago and underwent an MRI at that time. This year, during a follow-up MRI, it was found that the previously blocked blood vessels from the stroke are no longer visible in the distal segment. Is thi...

Dr. Cai Zongzhang Reply:
Hello Wenwen: Magnetic resonance angiography may not show blood vessels, which does not necessarily indicate complete blockage; it could be due to vascular narrowing and slow blood flow. Using anticoagulants is a reasonable preventive measure against stroke, but it should be used...

Understanding Stroke: Exploring Links Between Car Accidents and Brain Infarction

Cerebral infarction (stroke) Hello, I had a car accident on December 9, 2022, and initially only sustained some external injuries. However, on January 12, 2023, I suddenly experienced a loss of vision and went to Tzu Chi Hospital to see a neurologist. An MRI revealed that I had a...

Dr. Cai Zongzhang Reply:
Hello, A-You: The causes of cerebral infarction are not directly related to trauma; it may be necessary to investigate other rare causes of cerebral infarction. The recovery period for neurological damage is lengthy, and complete recovery is often difficult, with most patients ex...

Managing Daytime Sleepiness in Patients with Sleep Apnea

Easily feeling sleepy? I often feel sleepy during afternoon video courses, so I lie down and take short naps before continuing. I have sleep apnea and weigh 118 kg. What should I do about feeling sleepy?

Dr. Jiang Junyi Reply:
Hello, sir: You mentioned the issue of "sleep apnea," which can lead to daytime inattention and frequent drowsiness. Obstructive sleep apnea is the most common type, accounting for about 90% of cases. Soft tissue near the throat obstructs the airway, causing the upper a...

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