Clay-Shoveler's Fracture

The clay-shoveler's fracture is a lower cervical spinous fracture commonly occuring at C7 but can occur anywhere between C6 to T3. It is a result of hyperflexsion of the neck that is often experienced when shoveling snow. The term Clay-Shoveler's fracture, originated in Western Australia that was coined after relief works that fracture the same area of their lower cervical spine while shoveling clay. Most of these previously unemployed men were out of shape while trying to shovel clay out of a 15 ft deep ditch with long handled shovels. The clay stuck to their shovels while thrusting them upward. Coincidently, all of the men reported that at the peak of the upward motion they felt a sharp stabbing pain and heard a crack right between their shoulders. The medical explaination of this accident is that the force from the muscles in the back (trapezius and rhomboid muscles), pulled and fractured the spinous process of the seventh cervical vertebra. This partially explains how the Clay-Shoveler's fracture usually happens to laborers who perform activities that involve lifting objects rapidly with arms extended. Examples are of these activities are shoveling snow, soil or grubble up and over the head backwards, using a pickax or even something simple like picking roots!

SYMPTOMS: burning, knife-like pain at the level of the factured spine between the upper shoulder blades. Repeat activity with the muscles of the upper back can increase the sharp-like pain.

DIAGNOSIS: can be diagnosed by x-ray examination

The pain can sudside in days to weeks on it's own but can gradually return in activites that involve prolong extending of the arms like something as simple as computer work.

TREATMENT: most patients require no treatment. A massage, physical therapy or pain medication can relieve pain. For long-lasting pain, surgical removal of the tip from the broken spine will cure the problem.

www.ejbjs.org/cgi/reprint/22/1/63.pdf

www.medterms.com/script/main/art.asp?articlekey=7988

www.jmedicalcasereports.com/content/2/14/187

Bow Hunter's Sydrome

Bow Hunter's syndrome is an uncommon condition in which the vertebral arteries is symptamatically occuled during neck rotation. This mechanical occlusion or stenosis can sometimes result into a Bow Hunter's stroke. As we all know, the vertebral arteries supply blood to the posterior part of the brain by way of the basilar artery and then the posterior cerebral arteries. In some special cases of Bow hunter's syndrome, patients can have what appears to be a normal vertebral artery on one side but on the opposite side can have an occluded artery while their head is in a nuetral position. Usually one of the vertebral arteries become occuled when turning their head a specific degree to one side while the other side becomes occluded in the c1-c2 area of the cervical spine. Stenosis of the vertebral artery can be in result of a cervical spine abnormality that pinches the blood flow when traveling through the transverse foramen. Angiography is the most common procedure preformed to find the occlusion or stenosis of the artery. In most cases a vertebral angiography can locate where in the artery the occlusion originates or depicts the mass or tumor causing stenosis.







SYMPTOMS:


Are typically the same as in other stroke victims: dizziness, vision disturbance, trouble speaking and walking, confusion and severe headaches.


The damage will start immediatly after the infarction occurs. If ever experiencing these symptoms go to the nearest emergency room for medical assistance. The sooner the better for a chance at full recovery.






TREATMENT:


Angiography followed by and interventional procedure angioplasty and stenting.


www.medhelp.org/posts/...Bow Hunter's Syndrome
www.ncbi.nih.gov/pubmed/19838975

VGAM

The acronym, VGAM stands for Vein of Galen malformation which is a congenital vascualr malformation of the brain. This is an unique type of AVM because the capillaries that normally slow down blood flow is absent resulting in no exchange of oxygen and nutrients to the surrounding tissues in the brain. Blood is immediately rushed and deposited from the cerebral arteries and into the vein of Galen. This increase of blood is almost immediatly circulated into the heart resulting in congested heart failure. Occasionally the defect can be detected with an ultrasound before birth but is usually diagnosed in infants that are experiencing rapid heart failure. In less severe cases, a child may develope hydrocephalas because of the enlarged malformation that blocks the the usual flow and aborption of CSF. Associated findings include ischemic changes such as a stroke and muscle weakness on one side of the body (hemiparesis). VGAM is prodominately found in the neonatal period or later in early childhood. Both boys and girls are affected equally and occurs in all races.

http://www.childrenshospital.com

http://emedicine.medscape.com

Chronic Sinusitis

Chronic sinusitis is inflammation of the paranasal sinuses that are the result of viral, bacteral, fungal, allergic or autoimmune diseases. The inflammation interferes with drainage and causes mucus to build up. Also known as rhinosinusitis and considered to be the same as nasal polyps but as a worst case senerio of rhinosinusitis. Rhino, meaning nose, and sinuses, the cavities in the skull can form nasal polyps (tissue swellings) that can obstruct the air passage ways of the nose. When the mucosal linning in the nasal cavity becomes infected the mucaosal glands start to secrete large amounts of mucus that fills the cavity. Chronic sinusitis is one of the four different subtypes which causes can vary due to the different conditions. The other three forms are acute, subacute, and recurrent acute sinusitis. Chronic sinusitis is the most debilitating form that can lead to physical symptoms as well as substantial functional and emotional impairement. The physical symptoms can be extremly painful from the tissues of the nose being irratated and swollen for the minimal of twelve weeks. A long term duration of symptoms is as followed:
Nasal polyps
Cystic fibrosis
Nasal obstruction

Other symptoms are:
Ear pain
Sore throat
Bad breath(halitosis)
Fatigue or irrtability
NAUSEA

Causes of chronic sinusitis may be causesd by a variety of reasons:
Viral, bacterial & fungal growth
Allergic diseases
Autoimmunity diseases

When to see a Doctor ?
You may have several episodes of acute sinusitis that last more than four weeks and keep reoccuring before developing chronic sinusitis. You may be reffered to an ear, nose and throat specialist for evaluation and treatment. See a doctor if you have:
If you have sinusitis a number of times and condition fails to respond to treatment.
If you sinusitis that last more than 7 days.

Treatments:
Saline nasal sprays
Oral, Injected, or Nasal corticosteroids
Decongestants
Over the counter drugs:(
Aspirin-NEVER GIVE ASPIRIN TO CHILDREN

Test and diagnosis:
Nasal Endoscopy
Imaging studies
Nasal ans sinus cultures
Allergy test

Sources:
http://www.mayoclinic.com
http://www.webmd.com

Graves Disease

Graves Disease

WHAT IS GRAVES DISEASE

First diagnosed by Sir Robert Graves in the early ninetheen century as the most common yet puzzling hyperthyroid pathology, is now believed to be an autoimmune disease. Autoimmunity is a weird phenom itself that occurs when the body produces antibodies and Tc cells that destroy its own tissues. If a diseased form is created , then it is known as an autoimmune disease, such as Graves disease which is started by the thyroid gland producing excessive amounts of thyroxine. Patients with this condition have abnormal amounts of antibodies in the serum of their blood that mimic TSH which continuosly stimulates TH release. Graves disease can occur by men or women but is more common in women after the age of 20 :(

SYMPTOMS

Elevated metabolic rates

Sweating

Tachycardia & Arrhythmia

Nevousness

Weight loss despite adequate food intake

Exophthalmos-protusion of the eyeballs may occur if the tissue behind the eyes becomes edematous and then fibrous.

TREATMENTS

There is no way you can stop your immune system from attacking your thyroid gland but treatments for graves diaease can ease symptoms and decrease production of thyroxine. One form is surgical removal of the thyroid gland or Radioctive iodine which will selectively destroy active thyroid cells . Left untreated can lead to serious complications and even death!

But once it is detected it is easily fixedby treatment.

http://webmd.com/

http://mayoclinic.com/

Empty sellar syndrome

What is Empty Sellar Syndrome?

Empty sella syndrome is the apperance, by a radiograph, that shows the sella turcica which usually houses the pituritaty gland, empty! After making a statement like this, one might ask how can a human function without the presence of the body's most important endocrine gland. After all, it only plays a major role in regulating the body's entire endocrine system by producing secretions that controls other endocrine glands that influence growth, metabolism and maturation. I don't mean to harp on this but the pituitary gland plays a part in every physiolocial process in the body. However, there is a reason for everything and the empty space is not always truly empty.

In Primary ESS, the voided appearance is a result of CSF that has entered the space normally occupied by the pituitary and has compressed the hypophysis against the wall of the sella turcica. Secondary ESS is the result of the pituitary gland regressing within the cavity after an injury, surgery or radiation therapy. Disease or tramua may reduce the size of the pituitary or completly eliminate it! Statistics from autopsies show that 5% to 25% empty sellar syndrome is found incidentally.

Causes and Symptoms

There are no known triggers or causative factors that relates to Primary ESS. Because of the unknown etiologic factors it is thought to be a congenital and accidental occurence by a failure or opening of the diaphragma sella. Secondary ESS is an acquired cause through a medical procedure, disease or truama. All of these reasons can contribute to the reduction in size or a complete absence of the gland. Sheehan's syndrome, is a specific type of acquired empty sellar syndrome, that is caused by infarction of the pituitary induced by shock or hemorrhage after labor and delivery.

Primary ESS: symptoms are usually associated with obesity and high blood pressure in women.

Secondary ESS: the condition is a byproduct of some other process leading to destruction and loss of pituitary functions, such as the ceasing of mestrual periods, inpotence, infertility, fatigue and an intolerance to stress and infection.

TREATMENT

Replacement therapy for any deficient hormone. All treatment would be symptomatic and supportive.

DIAGNOSIS

Empty sella syndrome is always diagnosed by some type of imaging study of the brain (x-ray, ct or mr)

PROGNOSIS

ESS is not a life-threatening illness but is a lifelong illness.

References:

http://www.nlm.nih.gov/medlineplus/ency/article/0

http://health.nytimes.com/health/guides/disease/empty

http://www.thamburaj.com/empty_sella.htm

Labrynnitis

Overview

Labyrinthitis is a pathogen that causes inflammation of the inner ear. Bacteria and viral infections from the head or respiratory tract can spread causing a disorder that involves swelling, fluid build-up(perilymph) and irritation of the inner ear. Labyrinthitis can also arise from exstreme stress, head injury, an allergy or as a reaction to medication.

Symptoms

Abnormal sensation of movement(vertigo)

Difficulty focusing the eyes because of involuntary eye movement

Dizziness

Hearing loss in one ear
Loss of balance, such as falling toward one side.
Nausea and vomiting
Tinnitus or other noises in the ear

Description

In structure, the labyrinth is a group of interconnected canals and chambers that houses the vestibular system of the inner ear. The vestibular system is made up of three semicircular canals that sense changes in rotational motion, gravity and linear motion. The brain combines visual cues with sensory signals from the semicircular canals to determine adjustments needed to retain balance. Labyrinthitis is caused by the inflammation of the labyrinth. When inflammation occurs the signal from the semicircular canals to the brain becomes affected resulting in it's most prominent and debilitating symptom acute vertigo.

Treatment

Labyrinthitis usually subsides within a few weeks. If infection continues your doctor may prescribe an antibiotic if bacteria is found to be the cause. In result of a viral infection, surgery may be required to drain fluid (perilymph) in the inner and middle ear. Treatment is focused on controlling the infection since most labyrinthitis usually resolves on it's own.

Diagnosis

A CT scan or MRI scan may be ordered if there is no history of recent infection. These scans help rule out other causes for vertigo, such as tumors. Blood test or fluid drainage from the ear can be tested to determine if bacteria is the cause of infection.

References

http://www.webmd.com/brain/tc/labryrinthitis-topic-overview

http://www.emedicinehealth.com/labyrinthitis/article_em.htm

http://www.healthscout.com/ency/68/644/main.html#cont