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Liu Yan Hao
Neurology
About me
Graduated from Henan University of Chinese Medicine in 2011, majoring in Integrated Chinese and Western Medicine for Brain Diseases, with a master's degree. Since graduation, I have been working in clinical practice in the departments of Brain Diseases, Kidney Diseases, and Rheumatology and Immunology.
Proficient in diseases
Specializes in the diagnosis and treatment of diseases such as cerebral infarction, cerebral hemorrhage, hypertension, dizziness, headache, stroke hemiplegia, kidney disease, rheumatic immune diseases, etc. with a combination of traditional Chinese and Western medicine.
Voices
Precautions for Stroke Patients Using Mannitol
Patients with stroke, if experiencing cerebral hemorrhage, extensive cerebral infarction, or cerebral embolism, can develop cerebral edema. In such cases, it is necessary to use mannitol for dehydration to reduce intracranial pressure. Therefore, it is crucial to strictly determine the appropriate indications. For patients with cerebral hemorrhage, cerebral embolism, or extensive cerebral infarction, the peak period of cerebral edema generally occurs between five to seven days, during which time mannitol should be used to lower intracranial pressure. If the acute phase has passed, then there is no need to use mannitol. For some patients, using mannitol weeks later not only lacks therapeutic effect, it might even worsen the condition. Additionally, when using mannitol, it is important to monitor the patient's renal function. In patients with renal insufficiency, the use of mannitol may exacerbate renal damage, so monitoring changes in renal function is essential. (Please use medication under the guidance of a doctor.)
Auxiliary examinations for cerebral embolism
Patients with cerebral embolism need to undergo a cranial MRI to observe the location of the embolism, the area of brain tissue necrosis, and the age of the lesion, which is helpful in assessing the severity of the disease and prognosis. Additionally, it is necessary to examine the cervical vasculature with Doppler ultrasound to check for the presence of carotid artery plaques, especially soft plaques which are prone to detachment and can form emboli, blocking cerebral vessels and potentially causing recurrence or exacerbation of cerebral embolism. Furthermore, an echocardiogram of the heart is required because another common source of emboli in cerebral embolism is mural thrombi in the heart, particularly in patients with arrhythmias or atrial fibrillation, who are more prone to form mural thrombi. Therefore, patients with cerebral embolism need to have an echocardiogram to check for the presence of mural thrombi. If present, anticoagulant medication is required for treatment. (Please use medications under the guidance of a professional physician.)
How to treat cerebral embolism?
Brain embolism generally blocks relatively larger cerebral blood vessels and often leads to extensive death of brain cells. Therefore, patients with brain embolism are primarily treated with medications that promote blood circulation and remove blood stasis to improve circulation. Additionally, patients with brain embolism often experience an increase in intracranial pressure, so it is necessary to use medications that reduce intracranial pressure and alleviate brain cell edema. Patients with brain embolism might experience disturbances in consciousness and are prone to develop aspiration pneumonia or dependent pneumonia, so anti-infection medications may be utilized for treatment. Some may also suffer from stress-related gastrointestinal ulcers, or even gastrointestinal ulcer bleeding, thus requiring medications that inhibit gastric acid secretion and protect the gastric mucosa. Other treatments target the cause of the condition. A common cause is the detachment of carotid artery plaques, therefore, medications that prevent arteriosclerosis and stabilize plaques are also used. (Please use medications under the guidance of a doctor.)
The difference between stroke and cerebral infarction
The difference between stroke and cerebral infarction lies in the scope of stroke, which is broader and includes cerebral infarction. Stroke is divided into hemorrhagic stroke and ischemic stroke. Common types of hemorrhagic stroke include cerebral hemorrhage and subarachnoid hemorrhage. Common types of ischemic stroke include cerebral infarction and cerebral thrombosis. Thus, the scope of stroke is relatively large and includes cerebral infarction. Cerebral infarction occurs when a blockage in the cerebral blood vessels leads to ischemia, edema, and necrosis of the brain tissue in the supplied area, resulting in symptoms of stroke. Additionally, cerebral embolism occurs when an embolus from another part of the body detaches and blocks a brain artery, causing ischemia and necrosis of the brain tissue in the supplied area, also leading to stroke.
Can a cerebral infarction be effectively treated?
Most cases of cerebral infarction can be treated effectively, except for some extensive cerebral infarctions, which may leave varying degrees of sequelae. During the acute phase of treatment for cerebral infarction, medications that promote blood circulation, improve circulation, prevent platelet aggregation, and anti-atherosclerosis drugs are used. If treatment can be administered within three hours of onset, intravenous thrombolysis can be performed, which may lead to a faster recovery if successful. Additionally, medications that eliminate free radicals are used during the acute phase to remove free radicals that damage brain cells. Other treatments involve the use of neurotrophic drugs to support the repair of damaged brain cells. After stabilizing the condition, active rehabilitation exercises are recommended, and most patients can be effectively treated.
What should I do if I have a migraine and feel nauseous?
Migraine-induced nausea can be symptomatically treated with oral pain relievers, medications that suppress gastric acid secretion, protect the gastric mucosa, and treat nausea. It is essential to confirm that the nausea is caused by a migraine rather than other acute cerebrovascular diseases. This is because migraine attacks do not pose a significant risk to health, and temporary relief from pain can be achieved by taking pain relievers orally. It's important to avoid staying up late and overworking to minimize the frequency of migraine attacks. If one experiences persistent severe headaches accompanied by nausea, conditions such as cerebral hemorrhage and subarachnoid hemorrhage must be ruled out, as these acute cerebrovascular diseases can be triggered. This is to avoid delaying treatment due to taking pain relievers. Therefore, it is crucial to understand the cause before proceeding with specific treatment. (Please administer medication under professional medical supervision and do not self-medicate.)
Subarachnoid hemorrhage clinical manifestations
Patients with subarachnoid hemorrhage typically exhibit persistent, severe headaches accompanied by projectile vomiting. Patients often experience symptoms of clouded consciousness, irritability, and anxiety. The most common cause of subarachnoid hemorrhage is the rupture of cerebral aneurysms, with blood entering the subarachnoid space, stimulating the pia mater and arachnoid membrane, and inducing severe headaches. This also leads to a rapid increase in intracranial pressure, causing projectile vomiting. Additionally, symptoms often include clouded consciousness and restlessness. Treatment requires complete bed rest for four to six weeks, using hemostatic, analgesic, and sedative medications to allow the patient to rest quietly. (Use specific medications only under the guidance of a doctor, and do not self-medicate.)
Clinical manifestations of subarachnoid hemorrhage
The clinical manifestations of subarachnoid hemorrhage include severe headache, projectile vomiting, and neck stiffness, sometimes accompanied by disturbances in consciousness. Some describe the headache caused by subarachnoid hemorrhage as the most severe headache of their lives. This severe pain is due to the congestion stimulating the meninges, causing pain that is typically very severe. Because the bleeding into the subarachnoid space allows blood to enter between the pia mater and the arachnoid membrane, stimulating the meninges and leading to these severe headaches, it causes a rapid increase in intracranial pressure and projectile vomiting. Patients may exhibit disturbances in consciousness and symptoms of irritability. This condition is considered a severe medical emergency that requires hospitalization for comprehensive treatment, with strict bed rest for four to six weeks, and it has a very high mortality rate.
Can you drink alcohol with a migraine?
Patients with migraines can appropriately drink some white liquor or beer, which is generally not a problem, but they must not drink red wine. This is because red wine and dairy products, such as cheese, can induce migraine attacks. Additionally, pickled foods like pickled vegetables contain nitrites, which can also trigger migraine attacks; therefore, it is best to avoid pickled foods as much as possible. Typically, before a migraine attack, there is a precursor symptom where vision changes occur. After these precursor symptoms disappear, migraine symptoms emerge. During a migraine attack, oral pain relievers can be taken for symptomatic treatment. Some patients may find relief on their own a few hours after not taking medicine. Symptoms may recur, so it is generally advised to identify and avoid these triggers to prevent migraine attacks.
Symptoms of cerebral infarction
Patients with cerebral infarction may exhibit paralysis of one side of the body and aphasia. If the patient has a brainstem infarction, symptoms may include unclear speech, difficulty swallowing, and coughing while eating. In cases of cerebellar infarction, there may not be symptoms of hemiplegia; the main symptom is usually dizziness. Additionally, large-scale cerebral infarctions can lead to disturbances in consciousness, manifesting as coma. Typically, cerebral infarctions do not affect consciousness unless they are extensive, which may also lead to coma. Moreover, patients with cerebral infarction often experience symptoms while resting quietly, commonly waking up in the morning to find themselves unable to speak or with paralysis on one side of the body, although their consciousness remains clear. These are typical manifestations of cerebral infarction.