Managing AVM Complications: Insights on Treatment Options and Transfers
Arteriovenous malformation of the brain with associated intracerebral hemorrhage? Dear Doctor: My family member, in their forties, was diagnosed with an arteriovenous malformation (AVM) two years ago. After angiography, surgery was deemed too risky due to the deep location of the...
Dr. Zhang Junwei Reply:
Currently, there does not seem to be a better treatment option available, but since each individual's condition varies, it is still recommended to have a detailed consultation in an outpatient setting.[Read More] Managing AVM Complications: Insights on Treatment Options and Transfers
Head Injury from Bumping: When to Seek Medical Attention?
Head trauma - impact injury Doctor, I have a question. This afternoon (February 28), while I was organizing my home, I squatted down to look for something. When I stood up, I forgot there was something above me and instinctively stood up, resulting in a significant impact on the ...
Dr. Lai Zhaokang Reply:
Hello: You experienced an incident on February 28, and today is March 1, which means it has been nearly 24 hours. If your symptoms persist, especially if you have severe headaches, nausea, vomiting, seizures, or weakness in your limbs, you should see a doctor as soon as possible....[Read More] Head Injury from Bumping: When to Seek Medical Attention?
Should Skull Reconstruction Be Done for Comatose Patients After Severe Head Injury?
In cases of severe head trauma from a car accident where the patient has been in a coma for several months, is it necessary to first repair the skull? My mother is in her 50s and was involved in a serious car accident in mid-October, resulting in severe head trauma and coma, alon...
Dr. Zhao Shaoqing Reply:
Hello: For general traumatic brain injuries, early assessment and reduction of swelling are important. If possible, skull fractures can be repaired early, which can be beneficial for brain recovery. You may want to consult with a neurosurgeon for evaluation at Changhua Hospital, ...[Read More] Should Skull Reconstruction Be Done for Comatose Patients After Severe Head Injury?
Understanding Spinal Fusion Surgery: Risks and Benefits for Seniors
Evaluation of Spinal Fusion Surgery Hello, doctor. My mother is 71 years old and has chronic diseases. Currently, she experiences difficulty walking for extended periods, accompanied by lower back pain and numbness in both legs. She has undergone X-rays and an MRI, and the doctor...
Dr. Lai Zhaokang Reply:
Hello: Spinal disorders that compress nerves can cause symptoms such as aching, cramping, numbness, weakness, and limping. While these conditions are not life-threatening, they can significantly impact quality of life and dignity. In severe cases, they may lead to impaired mobili...[Read More] Understanding Spinal Fusion Surgery: Risks and Benefits for Seniors
Head Injury Concerns: When to Seek Medical Attention After a Bump
Head trauma Hello doctor, yesterday when I was closing the rear car door, I accidentally hit my dad's head without noticing. He was conscious at the time but felt a lot of pain and has a small bruise on the top of his head. Today, he has no other discomfort. Is there a possi...
Dr. Zhang Junwei Reply:
The likelihood of intracranial hemorrhage is low; however, if there is persistent headache and dizziness, immediate medical attention should be sought.[Read More] Head Injury Concerns: When to Seek Medical Attention After a Bump
Post-Surgery Pain Management: Understanding Discomfort After Disc Surgery
Hello Dr. Lai: Issues after intervertebral disc herniation surgery? Dear Director Lai, I apologize for taking up your time with this lengthy message, but I would like to know what the next steps should be. 1. After waking up from surgery, I experienced pain in my left lower bac...
Dr. Lai Zhaokang Reply:
Hello: 1. After lying flat for an extended period, the compressed nerves can become more vulnerable. Under certain conditions, poor blood circulation in the surrounding area may trigger pain and numbness, which is not uncommon. You can apply warmth through heat packs, adjust yo...[Read More] Post-Surgery Pain Management: Understanding Discomfort After Disc Surgery
Post-Surgery Pain After Lumbar Disc Herniation: What to Expect?
Postoperative care for herniated disc surgery? Hello Doctor, I underwent traditional surgery for an L4-L5 herniated disc at the beginning of November, without the use of a spacer. Postoperatively, my calf pain improved, but in early January, I suddenly experienced persistent shoo...
Dr. Lai Zhaokang Reply:
Hello: After your decompression surgery in November, there was improvement, but in January, you experienced a recurrence of symptoms. I would like to speculate that it may be a relapse; of course, adhesions or other reasons are also possible. I recommend that you return for a fol...[Read More] Post-Surgery Pain After Lumbar Disc Herniation: What to Expect?
Understanding Irregularities in the Occipital Region: A Neurosurgical Perspective
Regarding the issue of irregularities in the occipital region? Hello, doctor. About a month ago, I noticed some irregularities in the center of the back of my head (specifically at the intersection of a line extending horizontally from the upper part of my ear and a line extendin...
Dr. Lai Zhaokang Reply:
Hello: 1. As your previous orthopedic doctor mentioned, it should be a normal skull. 2. A CT scan has also been performed, and if the doctor determines it to be normal, you can feel more at ease. 3. If you are still concerned, consider consulting a neurosurgeon for another evalua...[Read More] Understanding Irregularities in the Occipital Region: A Neurosurgical Perspective
Post-Spinal Surgery: Addressing Leg Stiffness, Weakness, and Tightness
Post-spinal surgery, experiencing stiffness and weakness in the legs, along with muscle tightness? Hello Dr. Lai! I have rheumatoid arthritis and underwent L4-L5 spinal surgery (with Romeo clamps and health insurance screws) in June 2022 due to pain from slippage. I had another s...
Dr. Lai Zhaokang Reply:
Hello: What you mentioned is all possible, and the treatment options can be considered. However, the key recommendation is to have your doctor arrange for a follow-up MRI for a detailed evaluation, and then plan the subsequent treatment strategy. Best wishes, Dr. Lai Chao-Kang, D...[Read More] Post-Spinal Surgery: Addressing Leg Stiffness, Weakness, and Tightness
Understanding Nerve Compression and Surgery Risks in Cervical Spondylosis
Cervical osteophytes compressing nerve edema? Consulting a physician: My mother is experiencing sharp pain in the right side of her back and stiffness in her neck and shoulders. Aside from these symptoms, there are no other issues. However, to clarify the cause of these problems,...
Dr. Lai Zhaokang Reply:
Hello: You are correct, and the doctor is also correct; this is actually a matter of risk assessment and probability (high probability events vs. low probability events). 1. MRI confirms that the nerve is being compressed, causing your mother's symptoms, which is the reali...[Read More] Understanding Nerve Compression and Surgery Risks in Cervical Spondylosis
Understanding Post-Concussion Symptoms: Headaches and Focus Issues
Head-related consultation? Hello, doctor. Four years ago (during middle school), I slipped and fell while running in a hurry, hitting the back of my head. Since then, I've experienced some mild migraines and difficulty concentrating. Is this considered a normal aftereffect? ...
Dr. Lai Zhaokang Reply:
Hello: 1. If you started experiencing symptoms such as migraines and difficulty concentrating immediately after the impact, it may be a post-concussion syndrome. However, it is uncommon for these symptoms to persist for more than three months. 2. If you developed the aforemention...[Read More] Understanding Post-Concussion Symptoms: Headaches and Focus Issues
Managing Neck Pain and Chest Discomfort: Insights from Neurosurgery
Chest pain, back issues? Last week, I visited a neurosurgeon and underwent an MRI. The report is as follows: **Summary Imaging Findings** Multiplanar multisequence MRI of the cervical spine without contrast enhancement shows: - **Alignment**: Grade I retrolisthesis at C4-5 ...
Dr. Lai Zhaokang Reply:
Hello: Please describe your symptoms to the rehabilitation physician and provide the aforementioned cervical spine MRI report or images to the doctor. Ask for their opinion and request to arrange a rehabilitation program, which will generally focus on cervical traction. Best wish...[Read More] Managing Neck Pain and Chest Discomfort: Insights from Neurosurgery
Chronic Brain Hemorrhage: Understanding Delayed Diagnosis and Treatment Options
Chronic cerebral hemorrhage with hematoma compressing the brain? Hello Dr. Zhang, my father (born in 1943) had a severe head injury from a fall down the stairs at the end of August, resulting in significant bleeding that required emergency care. A CT scan at that time showed only...
Dr. Zhang Junwei Reply:
Without detailed CT scans and neurological examinations, it is not possible to determine an accurate treatment plan. It is recommended to bring the discharge summary and CT scans to an outpatient appointment for discussion with the physician.[Read More] Chronic Brain Hemorrhage: Understanding Delayed Diagnosis and Treatment Options
Managing Post-Car Accident Symptoms: Effective Treatments for Pain Relief
Post-traumatic sequelae from a car accident? I was involved in a car accident in mid-July last year when I was stopped at a red light and was rear-ended. At that moment, my knees hit the trunk of the car, resulting in a blunt injury to my lower back. The next day, my knees were b...
Dr. Lai Zhaokang Reply:
Hello: 1. Lower back pain and leg numbness are suspected to be related to lumbar spine conditions. 2. There is a herniation at the fifth lumbar intervertebral disc, and water-cooled radiofrequency treatment could be considered. However, it is recommended to seek medical attention...[Read More] Managing Post-Car Accident Symptoms: Effective Treatments for Pain Relief
Understanding Complications of L3 Spinal Surgery: A Patient's Journey
Misplacement of L3 pedicle screw in lumbar spine surgery? Hello, doctor. My father is 72 years old. Preoperative X-rays showed signs of scoliosis and spondylolisthesis, with complaints of inability to walk for long periods due to lower back pain and numbness in his legs when sitt...
Dr. Lai Zhaokang Reply:
Hello: 1. Postoperative follow-up shows that the original symptoms have not improved and have worsened after surgery. If imaging reveals that a steel screw has penetrated the nerve canal, there are no other options but to adjust and perform another surgery (unless the patient is ...[Read More] Understanding Complications of L3 Spinal Surgery: A Patient's Journey
Understanding Shoulder and Neck Sounds: When to Seek Medical Advice
Shoulder and neck sound concerns? Recently, I've been experiencing occasional cracking sounds at the junction of my shoulder and cervical spine. Sometimes, even when I move my shoulder or take a deep breath, I hear noises, but it doesn't happen when I only move my neck....
Dr. Lai Zhaokang Reply:
Hello, it is suspected that the joint connecting the shoulder to the cervical spine is producing abnormal sounds. This may be due to being underweight, lack of exercise, and insufficient flexibility. The noise during movement could be attributed to a lack of synovial fluid, simil...[Read More] Understanding Shoulder and Neck Sounds: When to Seek Medical Advice
Understanding Foot Pain: When to See a Neurosurgeon or Other Specialist
Foot pain issues? Hello, Doctor. This morning when I woke up, I experienced a sharp pain in the area of the inferior extensor retinaculum, especially within the first hour after getting up. Currently, the pain occurs occasionally. I would like to know if I should see a neurosurge...
Dr. Lai Zhaokang Reply:
Hello, it is recommended to initially consult with a neurosurgeon, orthopedic surgeon, or rehabilitation specialist. Best wishes to you. By Dr. Lai Chao-Kang, Neurosurgery Department, Changhua Hospital.[Read More] Understanding Foot Pain: When to See a Neurosurgeon or Other Specialist
Understanding Sciatica: Symptoms, Treatment Options, and When to Consider Surgery
Herniated disc I have already seen a rehabilitation specialist. I am 20 years old and have been diagnosed with spinal stenosis at a specific lumbar vertebra, which is compressing the nerve, leading to sciatica. Currently, I am undergoing stretching exercises and electrical therap...
Dr. Lai Zhaokang Reply:
Hello: If you have already made efforts in rehabilitation and your symptoms have not improved, it is recommended to consult a neurosurgeon. Bring your MRI scans for evaluation to see if other treatments can be considered, such as lumbar nerve block or minimally invasive spine sur...[Read More] Understanding Sciatica: Symptoms, Treatment Options, and When to Consider Surgery
Understanding Minimally Invasive Surgery for Disc Herniation: Key Insights and FAQs
Hello Director Lai: I would like to ask you for educational information regarding my herniated disc? Hello Director Lai, thank you for taking the time to respond. Considering economic factors and my limited understanding of medical terminology, I am reaching out to you online for...
Dr. Lai Zhaokang Reply:
Hello: A. I see that you are seriously researching this topic, but you might be overwhelmed by the vast amount of information available online, leading to confusion. Many young internet users face similar challenges, getting misled by technical jargon and certain medical advertis...[Read More] Understanding Minimally Invasive Surgery for Disc Herniation: Key Insights and FAQs
Understanding Post-Coma Care Options After Brain Hemorrhage
Subsequent Issues Following Coma Due to Cerebral Hemorrhage Hello Doctor, I would like to inquire about my mother, who is 83 years old. A month ago, she suffered a massive hemorrhagic stroke in the right hemisphere of her brain that nearly crossed the midline. She underwent an em...
Dr. Zhang Junwei Reply:
Without detailed medical history, it is difficult to provide an answer. However, if the condition is severe enough that the physician determines there is no possibility of recovery, and the family agrees not to pursue aggressive treatment, then performing a drainage procedure may...[Read More] Understanding Post-Coma Care Options After Brain Hemorrhage