Gastric Vertigo: Can Stomach-ache and Vertigo Occur Together?

By Dr.Ravindra Patil

The answer, surprisingly, is ‘yes’.

Can ‘gas’ (meaning a bloated feeling in the stomach) cause dizziness? Yes, it can. Stomach conditions can indeed cause dizziness. Hence it is sometimes referred to as ‘Symptoms of Gastric Vertigo’. A gastric problem is sometimes associated with dizziness. Let us see gastric problem symptoms and their association with dizziness.

Abdominal pain can be caused by a wide variety of conditions like infections, food poisoning, ulcers, or some cancers.

Abdominal pain, or stomach aches, and dizziness often go hand in hand. In order to find the cause of these symptoms, it’s important to know which one came first, the stomach problem, or the dizziness.

Pain around your stomach area can be localized or felt all over, affecting other areas of the body. Many times, dizziness comes after abdominal pain as a secondary symptom.

Both are often thought to be the same, however they are different. While dizziness is a range of feelings that make you feel unbalanced or unsteady.  You feel as if the room or the world is revolving around you. Dizziness is often because of minor causes and is transient. While it is a condition that often needs medications and other therapies. Both can be symptoms of many diseases. But dizziness is never thought of as a disease. Dizziness is only a symptom. While in some cases, it is thought of as a disease.  

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Symptoms of Vertigo

Let us start with abdominal pain and its different types. It can be:

• Sharp pain
• Dull aching pain
• Gnawing pain
• Ongoing pain
• On and off pain
• Burning pain
• Cramp-like pain
• Episodic, or periodic pain
• Consistent pain

Severe pain of any type can make you feel lightheaded or dizzy. Stomach aches and dizziness often go away without treatment. You may feel better after getting some rest. Either sit or lie down and see if you notice a difference.

But if your abdominal pain and dizziness also accompany other symptoms, such as changes in vision and bleeding, it can be a sign of an underlying medical condition.

Make an appointment with your doctor if your symptoms are caused by an injury, interfere with your day-to-day activities, or are getting progressively worse.

In rare cases, chest pain can mimic abdominal pain. The pain moves to your upper stomach area even though it starts in the chest.

Visit a hospital emergency room immediately if you feel:

• An abnormal heartbeat
• Light-headedness
• Chest pains
• Shortness of breath
• Pain or pressure in your shoulder, neck, arms, back, teeth, or jaw
• Sweaty and clammy skin
• Nausea and vomiting

These are symptoms of a heart attack and require immediate medical attention.

Possible causes of abdominal pain and dizziness

Surprisingly, there are many conditions which cause abdominal pain or discomfort and dizziness. Some of them may seem to be not so important, but remember, this data is collected over years of study and compilation. Some of these conditions are medical emergencies and need immediate care.

• Appendicitis
• Ectopic pregnancy
• Pancreatitis
• Food poisoning
• Gastrointestinal bleeding
• Fertilizer and plant food poisoning
• Toxic megacolon
• Intestinal or gastric perforation
• Abdominal aortic aneurysm
• Peritonitis
• Gastric cancer
• Addisonian crisis (acute adrenal crisis)
• Alcoholic ketoacidosis
• Anxiety disorder
• Agoraphobia
• Kidney stones
• Hypoglycaemia (low blood sugar)
• Ileus (The inability of the intestine to contract normally leading to a build-up of food material)
• Chemical burns
• Stomach flu
• Abdominal migraine
• Drug allergy
• Indigestion (dyspepsia)
• Premenstrual syndrome (PMS)
• Painful menstruation
• Peripheral vascular disease
• Isopropyl alcohol poisoning
• Endometriosis
• Motion sickness
• Excessive exercising
• Dehydration

What can cause abdominal pain and dizziness after eating?

Postprandial hypotension

It means low blood pressure after a meal. If you feel abdominal pain and dizziness after eating, it may be because your blood pressure hasn’t stabilized. This sudden drop in blood pressure after a meal is called postprandial hypotension.

Normally, when you eat, blood flow increases to your stomach and small intestine. Your heart also beats faster to maintain blood flow and pressure in the rest of your body. In postprandial hypotension, your blood decreases everywhere but the digestive system. This imbalance of postprandial hypotension can cause:

• Dizziness
• Stomach pains
• Chest pains
• Nausea
• Blurred vision

This condition is more common in older adults and people with damaged nerve receptors or blood pressure sensors. These damaged receptors and sensors affect how other parts of your body react during digestion.

Gastric ulcers

Ulcer means discontinuity of skin or mucous membranes which leaves a raw open area of the tissue beneath. A gastric ulcer is an open sore in the lining of your stomach. Stomach pain often occurs within a few hours of eating. Other symptoms that normally accompany gastric ulcers include:

• Mild nausea
• Feeling full
• Pain in the upper abdomen
• Blood in stools or urine
• Chest pains

Most stomach ulcers go unnoticed until a serious complication, such as bleeding, occurs. This can lead to stomach pains and dizziness from blood loss.

When to seek medical help?

Always seek immediate medical attention for any pain that lasts seven to 10 days or becomes so problematic that it interferes with your day-to-day activities.

Also, see a doctor if you’re experiencing abdominal pain and dizziness along with:

• Changes in vision
• Chest pain
• A high fever
• Neck stiffness
• Severe headache
• Loss of consciousness
• Pain in your shoulder or neck
• Severe pelvic pain
• Shortness of breath
• Uncontrolled vomiting or diarrhea
• Vaginal pain and bleeding
• Weakness
• Blood in your urine or stool

In addition, take an appointment with your doctor if you experience any of the following symptoms for more than 24 hours:

• Acid reflux
• Blood in your urine
• Headache
• Heartburn
• Itchy, blistery rash
• Painful urination
• Unexplained fatigue
• Worsening symptoms

This information is only a summary of emergency symptoms. Common sense must prevail to decide if you abdominal pain and dizziness are minor conditions or may be signs of serious conditions.

How are abdominal pain and dizziness diagnosed?

Your doctor will perform a physical exam and ask about your medical history to help make a diagnosis. If you explaining your symptoms in detail,it will help your doctor determine the cause.

For example, upper abdominal pain may be a sign of a peptic ulcer, pancreatitis, or gallbladder disease. Lower right abdominal pain can be a sign of kidney stones, appendicitis, or ovarian cysts.

Be mindful of the severity of your dizziness. It’s important to note that light-headedness feels like you’re about to faint, whereas it is the sensation that your environment is moving.

Experiencing it is more likely to be an issue with your sensory system. It’s usually an inner ear disorder rather than a result of poor blood circulation.

Differential Diagnosis

Myelomeningocele although easily diagnosed because of the sac protruding from the back, can be confused with many other birth defects like these:

• Terminal myelocystocele
• Sacrococcygeal teratoma
• Caudal neural tube defect
• Tail remnants:
• Rhabdomyosarcoma
• Curarinos syndrome
• Neuroenteric cyst
• Caudal regression syndrome

The above are rare and complicated disorders best handled by specialists.

How are abdominal pain and dizziness treated?

In some cases, abdominal pain and dizziness resolves without treatment. This is common for food poisoning, stomach flu, and motion sickness. Sadly, it is not the case always.

Treatments for abdominal pain and dizziness vary depending on the primary symptom and underlying cause. For example, a gastric ulcer may require medicine or surgery. Your doctor can recommend a specific treatment course to treat the condition.

Try to drink lots of fluids if vomiting and diarrhoea accompany your stomach pains. Lying or sitting down can help as you wait for symptoms to improve. You can also take medication to reduce stomach pains and dizziness.

How can I prevent abdominal pain and dizziness?

Tobacco, alcohol, and caffeine are linked to abdominal pain and dizziness. Avoiding excess consumption can help lessen these symptoms.

Drinking water during intense exercise can also help reduce stomach cramps and dehydration. It’s recommended to drink at least 4 ounces of water every 15 minutes when you are in the heat or exercising.

Also, be careful not to over-exercise to the point of vomiting, losing consciousness, or injuring yourself.

Myelomeningocele

By Dr.Ravindra Patil

Myelomeningocele is one of the forms of spina bifida and described as a sac containing liquid and nerve tissue protruding from the back. It occurs when there is an incomplete closure of the spinal cord during the first month of pregnancy.

Myelomeningocele generally occurs during embryonic development due to incomplete closure of the spinal neural tube during the first month of pregnancy. It ultimately leads to an exposed neural tissue or meninges with a fluid-filled sac that protrudes at the affected vertebral level.

Myelomeningocele can cause several neurological deficits and complications which are dependent on the involved vertebral site. It can lead to devastating morbidity and multiple disabilities; hence, the prognosis is often worse if diagnosed late or left untreated.

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Causes

Causes of myelomeningocele are many and include environmental, maternal, and genetic factors.

• Environmental factors include exposure to radiation, different types of pollution, pesticides, organic solvents, and teratogens.
• Maternal factors are numerous and include irregular maternal nutrition, low folic acid supplementation, caffeine and alcohol consumption, smoking, the use of anticonvulsants, in addition to certain maternal illnesses such as diabetes, obesity, hyperthermia, and anxiety. However, most of the cases of myelomeningocele are sporadic in origin and occur in a non-genetic pattern.
• Some genetic factors might increase the risk of occurrence, for instance, the presence of chromosomal anomalies of trisomy 18 or 13 and patients with an affected twin or first-degree relative.

Epidemiology

It is the branch of medicine which deals with the incidence, distribution, and possible control of diseases and other factors relating to health. The prevalence of myelomeningocele is approximately 0.8 to 1 per 1000 live births worldwide.

Physical Findings

In the new-born found to be suffering from myelomeningocele, there is a sac extending from the vertebral column, covered with meninges, filled with cerebrospinal fluid and neural tissue. The clinical symptoms are dependent on the site of the spinal lesion at the vertebral column. The higher the level affected, the more deficits occur, and the worse the future of the patient.

Complications in children with Myelomeningocele

Myelomeningocele is one of the most prevalent causes of neurogenic bladder in children.

Patients can have a life-long functional disabilities like paraplegia, sphincter dysfunction, motor and sensory impairments. Some might experience abnormal sexual development in adulthood.

Renal, respiratory, and cardiac complications are common causes of death in patients with spina bifida and Myelomeningocele.

A cerebellar tonsillar herniation [where a part of the small brain protrudes through foramen magnum] may occur in myelomeningocele. Other complications are hydrocephalus and syringomyelia. There are many more complications.

The degree of neurological impairment predominantly depends on the affected spinal cord level.

Evaluation

The diagnosis of myelomeningocele is possible in the first trimester of pregnancy when the foetus in inside the mother’s womb by ultrasonography. It is non-invasive, safe and effective. A careful examination of the foetal spine myelomeningocele if present. Test of the amniotic fluid may show higher levels of alpha-fetoprotein.

Other features of spina bifida that are visible through ultrasound include hydrocephalus, microcephaly, small-shaped cerebellum, and abnormal cranial bones.

Fast MRI gives a better visualization of the spine and neural elements as well as other organ systems associated with myelomeningocele and spina bifida.

Surgery on the foetus before birth

Once the diagnosis has made, early surgical repair of the spinal lesion is essential in preventing further deficits and neurological damage. Surgery before the birth of the baby has been proven to be more effective than surgery on the new-born to reduce the occurrence of complications in life of the children.

Surgery after birth

The myelomeningocele sac is everted and placed within the dural canal. The closure of the fascia then achieves the repair. Small-sized lesions are coverable by primary repair. However, the closure of large-sized myelomeningoceles could require either a flap or graft repair. Radiological imaging is done to exclude other associated anomalies.

Differential Diagnosis

Myelomeningocele although easily diagnosed because of the sac protruding from the back, can be confused with many other birth defects like these:

• Terminal myelocystocele
• Sacrococcygeal teratoma
• Caudal neural tube defect
• Tail remnants:
• Rhabdomyosarcoma
• Curarinos syndrome
• Neuroenteric cyst
• Caudal regression syndrome

The above are rare and complicated disorders best handled by specialists.

Early diagnosis better

Delayed diagnosis of myelomeningocele is associated with poor future of the child and lower rates of survival. Moreover, delayed and neglected management has links to various complications such as lifetime dependence, immobility, functional disability, muscle weakness, bladder, and bowel dysfunction etc. The presence of other disorders, such as hydrocephalus, increases the mortality rate in patients with myelomeningocele.

Complications

Complications of myelomeningocele are either surgical or non-surgical.

Surgical complications include infections at the site of the lesion, bleeding, delayed wound healing, re-tethering of the spinal cord, and cerebrospinal fluid leakage.

Non-surgical complications are:

• Neurological complications: Hydromyelia, Arnold-Chiari II malformation, hydrocephalus, seizures, paraplegia, motor, and sensory impairments.
• Musculoskeletal complications: scoliosis, muscle weakness.
• Physical complications: Immobility, delayed walking.
• Psychological complications: Depression, suicide, intellectual disability.
• Social complications: Educational problems, dependence, and unemployment.
• Sexual complications: Erectile dysfunction, impotence, and fertility problems.
• Other complications include obesity, renal failure, in addition to cardiac and respiratory diseases.
• Latex allergy: most patients with spina bifida have a sensitivity to latex allergenic protein.

Postoperative and Rehabilitation Care

Postoperative care primarily depends on the type of surgical procedure. If surgery is done before birth and foetal delivery is preterm, the baby should stay at a specialized neonatal intensive care unit in a latex-free environment. Subsequently, coordinated medical care should be followed to prevent other complications related to prematurity or foetal surgery.

Although foetal surgery gives better results than postnatal surgery, patients and mothers are at a higher risk of complications during and after the surgery.

To preserve the functional neurological level and improve the quality of life, long-term rehabilitation care is required.

Key Learning Points

Early surgical intervention before or within 24 to 48 hours after birth is essential to prevent more damage. It can improve the quality of living if followed by integrated medical care.

Nevertheless, children might require frequent medical evaluation and hospital visits to address their needs and complaints. Early medical management for children complaining of learning and cognitive disabilities in schools can help them prepare for their future education. Parents should be aware that the child might show a particular area of disability.

Having a child with spina bifida would increase the risk of having another affected child in subsequent pregnancies. To avoid the risk of another affected pregnancy, genetic counselling should be required before conception.

Increasing Healthcare Team Outcomes

Premarital and antenatal counselling should be a consideration for high-risk individuals. Regular antenatal examination and visits are essential to follow foetal development and address possible foetal and maternal complications.

Increasing awareness about spina bifida is significant to improve the outcomes of patients in their society. The good news is: 94% of spina bifida adults have finished a high school degree, and about 62% have completed a college degree in the USA.

Hence, there are no boundaries for patients to learn or be part of their community.

However, ignorance about the disease and its possible complications in addition to delaying therapeutic interventions and not providing adequate medical services would lead to more difficulties in the future and impact the quality of life.

Diet and Nutrition Deficiencies for Pediatric age

By Dr.Ravindra Patil

Diet

Right from birth, a healthy diet consumed throughout the life-course helps in preventing malnutrition in all its forms as well as wide range of non-communicable diseases (NCDs) and conditions. But rapid urbanization/globalization, increased consumption of processed foods and changing lifestyles has led to a shift in dietary patterns. Nutrition deficiency refers to the inadequate intake or absorption of essential nutrients needed for optimal growth and functioning of the body.

People are consuming more foods high in energy, fats, free sugars or salt/sodium, and many do not eat enough fruits, vegetables and dietary fibres such as whole grains. So, these all factors are contributing to an imbalanced eating.

A balanced diet is one which contains variety of foods in such quantities and proportion that the need of all nutrients is adequately met for maintaining health, vitality and general wellbeing and makes a small provision for extra nutrients to withstand short duration of deficiency.

The major food issues of concern are insufficient/ imbalanced intake of foods/nutrients.  One of the most common nutritional problems of public health importance in India are low birth weight, protein energy malnutrition in children, chronic energy deficiency in adults, micronutrient malnutrition and diet related non-communicable diseases. Health and nutrition are the most important contributory factors for human resource development in the country.

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According to WHO

• Infants should be breastfed exclusively during the first 6 months of life.
• Breast-milk alone is not enough for infants after 6 months of age. Complementary foods should be given after 6 months of age, in addition to breast-feeding.
• Feed low-cost home-made caloric and nutrient rich complementary foods.
• Infants cannot eat large quantities of food at a single time so they should be fed small quantities at frequent intervals (3-4 times a day).
• The food should be of semi-solid consistency so that the infants can swallow it easily. A balanced diet is the key to protect your child against nutritional deficiencies.
• Observe hygienic practices while preparing and feeding the complementary food for infants, because babies are prone to infections.
• Avoid junk foods for babies.

Diet for a Growing Child

Children who eat a balanced diet lay the foundation for a healthy and active lifestyle and this further lowers the risk of long term health issues. Childhood is the most critical time for growth as well as for development of the mind and to fight infections. So, it is very essential that the children get a good dose of energy, proteins, vitamins and minerals. It is very important to follow that hygienic practices are followed while preparing and feeding the complementary food to the child; otherwise, it might lead to diarrhoea.

Good food choices are:

• Milk, cheese, yoghurt.
• Vegetables like spinach, broccoli and celery which are rich in calcium is a must.
• Give them a daily intake of energy rich foods as whole grains (wheat, brown rice), nuts, vegetable oils, vegetables like potatoes, sweet potatoes, fruits like banana.
• Proteins are essentials for muscle building, repair and growth and building antibodies. So give them diet which has meat, eggs, fish and dairy products.
• Vitamins for the body to function properly and to boost the immune system. A variety of fruits and vegetables of different colours should be added in child’s food.
• Vitamin D helps in bone growth and is essential for absorption of calcium. Sources are sunlight and a small amount from some food items like fish oils, fatty fish, mushrooms, cheese and egg yolks.
• Teenage girls experience more physiological changes and psychological stress than boys because of onset of menstruation. Therefore, teenage girls should eat diet which is rich in both vitamins as well as minerals to prevent anaemia.
• Give plenty of fluids during illness. A child needs to eat more during and after episodes of infections to maintain proper nutritional status.
• The child must drink one to two and a half litres of water to hydrate its body. It is preferred to have water/buttermilk/lassi/fruit juices/coconut water over soft drinks and other packaged drinks.

Nutritional Deficiencies

Many diseases and morbid conditions result from nutritional deficiencies. Nutritional deficiencies are prevalent worldwide. Deficiencies may lead to long term chronic health problems such as rickets, iron deficiency anaemia, goitre, obesity, coronary heart disease, type 2 diabetes, stroke, cancer and osteoporosis.

Common Nutritional Deficiencies in Children

Iron Deficiency

Children need iron for a wide variety of bodily functions. It is a part of haemoglobin, a protein that carries oxygen from their lungs to the rest of their body where it assists their muscles in the storage and use of oxygen. Without enough iron children can develop anaemia which can lead to lethargy and improper cognitive functioning among other debilitating conditions. Meat, pork, poultry, seafood, beans, peas, lentils, dark green leafy vegetables, dried fruits, iron-fortified cereals, breads and pastas can all be quite rich in iron.

Vitamin D Deficiency

Vitamin D is essential for the absorption of calcium along with iron, magnesium, phosphate and zinc in the gastrointestinal tract. Adequate intake of this vitamin is necessary for optimal bone growth. Vitamin D deficiencies are more common in those children who have limited exposure to sunlight. Children can receive Vitamin D by eating fish and foods fortified with Vitamin D such as certain dairy products, soy milk, and cereals. Liver and egg yolks are also known to be rich in Vitamin D.

Zinc Deficiency

Zinc is a mineral essential to childhood growth, digestion, sex hormone development, and a strong immunity. A deficiency can negatively impact everything from hair, skin, and nails to cognitive functioning and the height of your child. Zinc can easily be added to your child’s diet through the introduction of sesame seeds, pumpkin seeds, squash seeds, cashews and peanuts, in addition to seafood, meat, cooked beans, peas and lentils.

Calcium Deficiency

Deficiency leads to poor teeth and bones, muscle dysfunctions, heart problems, blood clotting irregularities, enzyme dysfunction and so on. Children require a high calcium intake. Sources are milk and milk products, dark leafy green vegetables, soy, tofu, fish, almonds, seeds, and fortified cereals.

Vitamin A

Vitamin A deficiency (VAD) is common in poorer societies. Night blindness is one of the first signs of VAD, as the vitamin has a major role in phototransduction. Complete blindness can follow if the deficiency is more severe. Sources are yellow, red and green (leafy) vegetables, such as spinach, carrots, sweet potatoes and red peppers. Yellow fruit, such as mango, papaya and apricots.

Folic Acid or Folate Deficiency

Folate deficiency anaemia is the result It is characterized by the appearance of large-sized, abnormal red blood cells (megaloblasts), which form when there are inadequate stores of folic acid within the body.    Feed your child dark green leafy vegetables (turnip greens, spinach, romaine lettuce, asparagus, Brussels sprouts, broccoli), Beans, seafood and Peanuts to prevent folate deficiency.

Vitamin B12 Deficiency

Vitamin B₁₂ is important in the normal functioning of the nervous system and in the circulatory system in the maturation of red blood cells in the bone marrow. The only source is animal-derived foods or from supplements. Foods containing vitamin B₁₂ include meat, clams, liver, fish, poultry, eggs, and dairy products. Many cereals are fortified with the vitamin.

Spinal Deformity

By Dr.Ravindra Patil

What Is a Spinal Deformity?

A spinal deformity occurs when your spine deviates by more than 10 degrees from “healthy” curvature. But, what does this mean exactly?

Contrary to popular belief, your spine isn’t 100% straight. But oddly, your spine is also straight! How do we explain these two opposite statements?

The fact is that your spine consists of a series of gentle arcs. Your lumbar spine, or lower back, swoops slightly inward and your thoracic spine, or upper back, bends subtly forward. The inward curve of your lower back is known as lordosis and the outward curve that runs between your shoulder blades is known as kyphosis. These curves are seen when looking at a person’s spine from the side.

But, when looking from the front, your backbone should look like a straight pillar. (Hence, doctors often refer to the spine as the “vertebral column.” Column is something which is very much straight and vertical.

The curves of the spine are so adjusted that the curves and straight stretches of your spine make symmetry possible. Thus, your head sits directly over your pelvis because the lordosis of your lower back and the kyphosis of your upper spine balance each other out.

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Spine abnormal curvature

If one of these curves, lordosis and kyphosis, becomes greater or lesser than the other, then problems can emerge. We refer to this as sagittal imbalance, because the head and pelvis no longer fall within the same, or sagittal, plane. The sagittal plane is an imaginary plane that divides the human body equally into right and left sections.

Thus, too much backwards thrusting of the hips is lordosis and too much forward stooping in the upper back is known as kyphosis. These are two major spinal curvature deformity types.

Similarly, the spine can also tilt sideways, that is from the midline of the body, doctors refer to this problem as coronal imbalance or scoliosis. The coronal plane is an imaginary plane that divides the human body equally into the front portion and the back portion. Unevenness in the “coronal” plane (we can view the coronal plane when we look at a human body from the front) causes asymmetry in the trunk of the body. This can include uneven hips and shoulders or one-sided bulging of the ribs.

Spinal Deformities

As has been mentioned, any deviation from the sagittal curvatures of the spine, or any deviation in the coronal plane of the spine can be called spine deformities. There are many types of deformities of the spine.

What are the Symptoms of a Spinal Deformity

Spinal deformities can range in seriousness from mild to moderate or severe. However, in every spine deformity, pain is always present.

If you have pain or deformity in any region of the spine, you don’t have to live with the symptoms of spinal deformities or spinal pain any longer. A qualified and trusted surgeon, like Dr Ravindra Patil, of Samarth Neuro and Multi-speciality hospital even in a small city like Miraj can help you get relief from your painful symptoms and in some cases, your deformities can be corrected.

Spinal deformity types

As has been mentioned, the spinal deformities can change either the correct curvature of the spine or the correct uprightness of the spine. In addition, in some cases the vertebra can collapse because of osteoporosis and it may lead to shortening of the spine.

Scoliosis deformity

It is an abnormal side-to-side arc in the spine. If your spine curves to the right, then you have dextroscoliosis. If your spine curves to the left, then you have levoscoliosis. However, often, adult and paediatric patients with scoliosis will have more than one twist in their spine, that is the spine may curve in both right and left arcs.

Kyphosis

This occurs when the upper back develops a forward hump, sometimes referred to as hunchback. The shoulders will round forward, the head will jut out, and the torso will appear to slouch or droop over.

Lordosis

This often occurs as a side effect of kyphosis. Hyper-lordosis, or swayback, causes the lower back to swoop inward and the abdomen to jut outward.

Flatback Syndrome

This condition develops when the spine loses its natural curvature. This may sound benign. After all, the spine has become “straight.” But, flatback syndrome can cause patients to pitch forward, creating serious issues with walking.

Ankylosing Spondylitis

This form of arthritis can cause the spinal vertebrae to fuse together. When this occurs, your spine loses its mobility and your posture locks into one position.

Spondylolisthesis

Also known as a slipped vertebra, this condition can be caused by a birth defect in the spine. In the severest cases, a slipped vertebra can slide entirely off of the spinal column, a condition also known as spondyloptosis.

What Causes Spinal Cord Deformities?

Doctors sort spinal deformities into different groups according to their causes. Although many issues can cause spinal deformities, the most common include:

• Congenital: Some forms of spinal deformity develop before a child is born. Genetics and mishaps in the womb can cause this.
• Paediatric: Other forms of spinal deformity become more obvious in childhood. Scoliosis, for instance, often emerges between the ages of 10-12. Specifically, growth spurts may cause this jump in rates.
• Postural: Poor posture in key periods of spinal growth can cause the upper back to round forward. To fix this issue, muscle-strengthening and posture lessons may be needed.
• Neuromuscular: Certain disorders, like cerebral palsy, can alter muscle activity. As stiff muscles pull on the spine, the back and neck can lose their natural shape.
• Adult or Degenerative: Wear and tear on the spine can cause the discs in your back to degenerate. Weak vertebrae can fracture and develop a wedge-shape that leads to kyphosis. And, ligaments that support the spine can harden, pulling your back out of alignment.
• Traumatic: Injuries, like sudden blows to the back, can knock vertebrae out of place, altering the curvature of your back.
• Iatrogenic: This word refers to spinal issues, like flatback syndrome, that develop as the result of a failed spinal fusion.
• Idiopathic: When a spinal deformity develops for an unknown reason, the condition is said to be idiopathic. The majority of scoliosis cases, for example, are classified as idiopathic scoliosis.

Spinal deformities are serious conditions. They can destroy your self-esteem and prevent you from completing your day-to-day tasks. And, they can cause a lot of pain.

Fortunately, many forms of conservative therapy and surgical treatment are effective at managing pain and reversing your condition. If your condition requires treatment, you will begin by exploring non-surgical treatment options. These may include scoliosis bracing or physical therapy.

If your condition does not improve with these methods, then you may need spinal deformity surgery. Operative treatments for spinal deformities achieve correction in three main ways. They straighten and hold the spine in a better position (spinal fusion). They remove bone (osteotomy). Or, they use fusionless systems to encourage your spine to grow in a more ideal way.

For getting such surgeries done, you need not go to major cities. Such surgeries can be done in speciality centres like Samarth Neuro and Superspeciality hospital in Miraj, where the chief neuro and spine surgeon Dr Ravindra Patil has treated many such cases.

If the brain clot is large the surgeon may need larger access to the blood clot, requiring a different procedure called a craniotomy. During a craniotomy, the neurosurgeon will remove a section of the skull an opening and then remove the blood clot. When the procedure is complete, the surgeon will replace the section of bone and close up the soft tissue using sutures or staples.

Blood clot in brain surgery recovery is going to depend on the patient’s personal health factors. Besides most patients will spend a few days in ICU and about a week in wards or a private room. After discharge from hospital there will be activity restrictions for a few weeks. For craniotomy, recovery will take longer. The patient must educate himself/herself about the condition and further treatment.

Says Dr Daniel Hanley, M.D., professor of neurology at the Johns Hopkins University School of Medicine: “We’ve gone from what’s usually an 80 percent death rate in patients with this condition to an 80 percent survival rate!”
That is very good news indeed. So although getting a blood clot in brain due to an injury or a brain clot inside the cerebral artery are very serious conditions, there is a fairly large chance of recovery.

Blood clot in the brain surgery

By Dr.Ravindra Patil

Blood clots are good because they prevent blood loss. Clotting is a mechanism to prevent blood loss. If we sustain a wound, the blood clots and our bleeding stops.

However, sometimes the blood clots at the wrong places, like inside arteries or veins. If this happens in the arteries of the brain or the heart, it stops blood flowing to parts of brain or the heart. This causes cerebrovascular stroke or a heart attack respectively.

Or, there may be internal bleeding [called haemorrhage] and that causes space occupying lesions and sometimes this collection of blood pushes the brain to one side.

Luckily all the above conditions are treatable.

A blood clot in brain may refer to two separate entities. One is when a blood clot forms in the brain arteries, called cerebral thrombosis. It happens because of blood clotting inside cerebral arteries. Sometimes, a small blood clot can travel from another place [usually the lungs] and lodge itself in a brain artery. This is known as cerebral embolism. In Both the above conditions lead to cerebrovascular stroke or simply stroke. It is an extremely serious and life threatening condition.

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How are brain clots inside brain arteries treated?

Thrombectomy is a procedure to remove a blood clot from a blood vessel. It can be used for some people who’ve had a stroke. Blood clots in the brain can cause ischemic strokes. Thrombectomy can remove the clot and help blood to flow normally again.

Craniotomy and Burr-Hole surgery

The other type of clot in the brain may be due to head injury, which causes haemorrhage inside the brain. Depending on where the bleeding occurs, it is known as SDH [sub dural haemorrhage] or SAH [sub arachnoid haemorrhage] or EDH [epidural haematoma]. Such haemorrhage is also a very serious condition.

Both types of conditions of the above may need intervention in the brain or surgery to remove the blood clot or haemorrhage or dissolve the blood clot. In thrombosis and embolism the blood clot can be dissolved and they can be treated without surgery, as explained below.

Are ‘blood clot in brain’ and ‘brain clot’ the same?

Brain clot usually means a blood clot in the brain. The brain itself does not ‘clot’, blood does clot after injuries or as a result of diseased conditions. Hence ‘brain clot symptoms’ and ‘blood clot symptoms’ will be basically the same.

Is blood clot in brain dangerous?

Of course it is dangerous. It may lead to raised intracranial pressure, paralysis or death. Or it may lead to temporary or permanent loss of functions of certain areas of the body or certain motor activities like speech and movement etc.

What is the treatment of blood clot in brain?

Blood clot in brain treatment depends on the type of blood clot. If the clot is within the blood vessels, the clot can be dissolved by medicines like Alteplase, Streptokinase or Urokinase. Such clots can also be sometimes removed with DSA [digital subtraction angiography] procedures.

If there is blood clot in the brain as a result of injury [cerebral haemorrhage], craniotomy surgery or burr-hole surgery are done. In this type brain surgery for blood clot, the skull may be opened in different ways. The clot is removed, and the flap of the skull is replaced.

Reason for blood clot in brain

Blood clotting in brain in never a natural phenomenon. It is a sign of serious disease. A blood clot in the brain is typically the result of injury. The chance of a blood clot in the brain increases with age. The risk with factors that increase bleeding, such as anticoagulant medications and excessive alcohol intake.

Is Blood clot in brain treatment without surgery possible?

Treatment without surgery in any disease is always the most preferred option. In case of cerebral thrombosis or cerebral haemorrhage, blood clot dissolving enzymes are used to dissolve blood clots. They are called rTPA, Alteplase, Streptokinase or Urokinase.

However, cases of SAH or SDH or EDH can be treated only by removing the blood collection or blood clot by craniotomy or burr-hole surgery.

What happens after a blood clot in brain surgery?

During a craniotomy, the neurosurgeon removes a section of the skull in order to access the clot. The clot is then drained, and the section of the skull is secured back in place. Recovery after blood clot brain surgery will depend on a number of factors, including age, overall health and the reason why the clot developed in the first place.

How to treat blood clots in the brain?

There are two surgical methods to treat blood clots in the brain. These are burr-hole drainage and craniotomy. While performing burr-hole drainage, the neurosurgeon may create a hole within the skull followed by an incision to drain the blood clot. The area is then closed using sutures.

Symptoms of blood clot in brain

In cases of SDH, EDH or SAH, the intracranial pressure may increase. This leads to blood clot in brain symptoms like headache, blurred vision, feeling less alert than usual, vomiting, changes in behaviour, weakness or problems with moving or talking and lack of energy or sleepiness. Other brain blood clot symptoms may be drowsiness and confusion.

Surgery for Blood Clot in the Brain

What is the treatment for blood clot in brain? When there is a subdural hematoma in the brain, it can press on the delicate tissue of the brain, leading to damage and/or symptoms. This is one reason it is important to undergo treatment and prevent further complications.

Brain clot treatment

If the brain clot is large the surgeon may need larger access to the blood clot, requiring a different procedure called a craniotomy. During a craniotomy, the neurosurgeon will remove a section of the skull an opening and then remove the blood clot. When the procedure is complete, the surgeon will replace the section of bone and close up the soft tissue using sutures or staples.

Recovery after Brain Blood Clot Surgery

Blood clot in brain surgery recovery is going to depend on the patient’s personal health factors. Besides most patients will spend a few days in ICU and about a week in wards or a private room. After discharge from hospital there will be activity restrictions for a few weeks. For craniotomy, recovery will take longer. The patient must educate himself/herself about the condition and further treatment.

What are the chances of surviving a blood clot on the brain?

Says Dr Daniel Hanley, M.D., professor of neurology at the Johns Hopkins University School of Medicine: “We’ve gone from what’s usually an 80 percent death rate in patients with this condition to an 80 percent survival rate!”

That is very good news indeed. So although getting a blood clot in brain due to an injury or a brain clot inside the cerebral artery are very serious conditions, there is a fairly large chance of recovery.

Head injury and stroke treatment in Miraj

Reading the above may mislead the reader in thinking that treatment for stroke or cerebral haemorrhage after paralysis or a head injury may be possible only in large cities. It is not so. Even in tier two cities like Miraj all the above treatments are possible. Samarth Neuro and Super speciality hospital emergency department can handle such serious patients. If there is need for surgery, it can be done under the supervision of Dr Ravindra Patil, the chief neurosurgeon in Samarth Hospital.

Things to expect after brain surgery

By Dr.Ravindra Patil

Undergoing brain surgery is a major event in anybody’s life. In case you or your family member has to undergo brain surgery, it is useful to know something about brain surgery and how recovery happens after a brain surgery.

Brain Surgery can be a very traumatic experience, and it is common for many patients recovering from brain surgery to face depression, spells of dizziness, confusion and weakness post the surgery. It is very necessary that family members and friends talk to the patient and be empathetic towards them.

Brain surgery is done for many disease conditions like brain tumours, to treat cerebral haemorrhage, to treat trigeminal neuralgia, to treat epilepsy, to treat parkinsonism, to treat hydrocephalus and many other conditions. From the point of view of a patient or a care taker, these points are worth knowing.

Table of Contents

The wound

Brain surgery may be done by a craniotomy or burr-hole surgery. In both, the skin will be opened by an incision and closed by sutures or staples to close the wound. The sutures or staples have to be removed after a week or more.

Tube from brain to abdomen

In hydrocephalus, there is too much cerebrospinal fluid. Hence a surgery is done by placing a tube from the brain to the abdominal cavity so that excess cerebrospinal fluid is drained off to the abdomen.

The bone flap

In craniotomy if a part of the skull [called a bone flap] is removed, it is washed, sterilised and sealed in a plastic packing and stored with the name of the patient written on the package. The bone flap is attached to the skull after a few months. In some cases, the bone flap is preserved inside the abdomen of the patient himself/herself.

Risk of infection

Like any wound, the wound of the brain surgery is likely to suffer infection if proper wound care is not taken. So before surgery, the scalp hair is shaven. The scalp is cleaned with soap and water and then various antiseptic solutions. After surgery the surgical wound is cleaned and covered with sterile dressing and bandage. Never let the bandage get wet. Best of all, never touch the bandage. Let the doctors and nurses do the dressing of the wound after surgery.

Risk of bleeding, the drain

After every surgery, there is a slight risk of internal bleeding. If blood accumulates inside the skull due to internal bleeding, it leads to many complications. To prevent collection of blood, drain may be kept in the wound or through a small hole away from the wound. This drain facilitates blood or fluid collection to be drained out.

But if your wound bleeds, it is best to visit the hospital immediately.

Personal hygiene

After getting discharged from the hospital after brain surgery, the patient’s body can be wiped with soapy water. Taking a bath is also safe, however, the patient may feel giddy and hence it is best to confine the patient to bed. Needless to state, the bandage or dressing on the head must never become wet. 

Medications

A course of antibiotics to prevent infection, pain killers to reduce pain, medicines to reduce acidity etc are usually prescribed. These must be taken regularly. Missing one dose doesn’t create a major problem, but not taking medicines at all must NOT be done.

Besides these meds, the patient must also take whatever medicines he/she took prior to the surgery. These may be for high BP, diabetes or any such long standing condition.

“He/she is not the same after surgery”

You may have heard the above about patients who underwent brain surgery. It may happen in some case. So be prepared for slightly disturbed memory or movements or such things after a brain surgery. Doctors still do not understand the temporary mental changes called delirium that actually are the most common brain disease and the least understood. It occurs after medications, illness, and surgery.

Mental Changes After Surgery and Medical Illness

The extremely common and little understood brain changes after surgery or illness includes confusion, delusions, and hallucinations. This is most often temporary, but might last hours, days, weeks, or even months. But, the more serious problems are those that develop cognitive problems and never recover. This can be quite subtle, but life changing. These include memory loss and lack of ability to concentrate that can last for years or be permanent.

Good news is that such things happen rarely. The neurosurgeon will explain the risks and benefits of surgery to the patient and his/her relatives fully before surgery. A patient undergoing surgery has to accept the possibility of risks to gain the benefits of surgical cure. One big problem is that people who need surgery are ill and that affects the brain. Hence it is not justifiable to blame the surgery for any cognitive or motor deficits after a brain surgery.

Our priority at Samarth Neuro and Super Speciality Hospital is to assist you in finding a treatment plan that is both suitable and affordable. Dr. Ravindra Patil, our chief neurosurgeon, possesses extensive expertise in performing various surgeries related to the brain and spine.

Causes of Brain Problems After Surgery

Does anesthesia affect the brain during surgery? What about the physical trauma of the surgery itself? Kidneys are affected by the surgery. If a surgery can damage other organs, it could also damage the brain. It is like a body wide inflammation. In the elderly, brain surgery may affect the brain.

How long does recovery need?

It takes approximately 12-18 months for the brain to heal after a brain surgery and slowly and gradually the patient will regain all his normal functions and get back to his daily routine. However, in that time they need the complete support and understanding of their families, as well may need help from therapists. This will help the patient in gaining back their independence as well as confidence in their abilities.

More tips to help you deal with a Brain Surgery patients

After brain surgery, a person may feel disoriented and have some speech or understanding disability for a while. Family members and friends are advised to take a pause when talking to the patient, so that he/she can easily understand the conversation. Speaking slowly is not recommended, as patients may recognize it and have an emotional outburst or feel hurt.

• While conversing with the patient, family members should keep reminding about the topic of conversation at different points to the patient, so that it is easier for him/her to participate in the conversation.
• Please do not react adversely in case of emotional outbursts, instead show love and patience to a person recovering from brain surgery.
• Make sure that the person recovering from brain surgery gets enough sleep and rest to recuperate.
• People interacting with a brain surgery patient should understand that the person’s ability to learn and remember may be reduced. It will improve daily, and any lapses in attention by the patient are not caused by any act of obstinacy. Your care and understanding will be essential for a person to recover.
• Family members should also make sure just to give enough care and not smother the brain surgery survivor. It is essential for them to regain their confidence and a sense of competence.
• Nurses create a nursing care plan for all patients, including those with head injuries, called the NCP for head injury patients.

Neuropsychological examination after surgery

Soon after brain surgery and 6 months later, and a year later, the patient should be taken to a neurologist and if necessary to a psychiatrist to see if he/she is recovering properly. Caregivers should watch out for emotional outbursts, like rage, uncontrollable laughter, withdrawal and depression. In case of such symptoms, it is advisable to take the patient for a check-up with a medical practitioner.