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What Does My CT Scan Test Report Indicate?
Question: hi Dr Sharka. am bk .mum is doing great.and ct scan has been done too .here is the result. Pls advice and recommend treatments. Tnk u.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome back to HCM!
I reviewed your mothers CT scan result and would conclude that she has suffered two small strokes in the basal ganglia and many other small strokes related to chronic small vessel disease.
All these changes seem to be related to uncontrolled hypertension.
I would recommend taking aspirin 80mg daily (if she has no contraindications) and statins (atorvastatin or simvastatin) every day until the end of her life.
I would also advise performing her blood lipid profile. Nevertheless, in such cases, based on the CT reports many studies have shown statins to be helpful in preventing further strokes even in the absence of dyslipidemia.
I would also recommend to closely monitor her blood pressure different times during the day and refer those values to her attending physician, in order to be able to make the proper changes to her antihypertensive therapy to maintain her blood pressure under control.
Regarding her pain, I would like to know what dose of gabapentine is she taking actually.
As her clinical situation is very improved (the pain), I would recommend continuing on this dose for at least 3 months and then consult with your neurologist and discuss the possibility of stopping gabapentine.
Hope to have been helpful!
Feel free to ask me directly at any time if you have any other uncertainties.
Best wishes!
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome back to HCM!
I reviewed your mothers CT scan result and would conclude that she has suffered two small strokes in the basal ganglia and many other small strokes related to chronic small vessel disease.
All these changes seem to be related to uncontrolled hypertension.
I would recommend taking aspirin 80mg daily (if she has no contraindications) and statins (atorvastatin or simvastatin) every day until the end of her life.
I would also advise performing her blood lipid profile. Nevertheless, in such cases, based on the CT reports many studies have shown statins to be helpful in preventing further strokes even in the absence of dyslipidemia.
I would also recommend to closely monitor her blood pressure different times during the day and refer those values to her attending physician, in order to be able to make the proper changes to her antihypertensive therapy to maintain her blood pressure under control.
Regarding her pain, I would like to know what dose of gabapentine is she taking actually.
As her clinical situation is very improved (the pain), I would recommend continuing on this dose for at least 3 months and then consult with your neurologist and discuss the possibility of stopping gabapentine.
Hope to have been helpful!
Feel free to ask me directly at any time if you have any other uncertainties.
Best wishes!
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hi Dr, u recommended gabapentine 300mg.pain has also reduced a lot.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
I know I recommended increasing the dose of Gabapentine up to 900mg daily.
I just wanted to know if she is still taking such dose?
In such case, I would recommend continuing taking Gabapentine at her actual dose for other 3 months.
After this period, if she is feeling OK and the pain is not coming back, you should discuss with her attending physician on the possibility of gradually stopping this therapy.
Hope to have been helpful!
Best regards!
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello again!
I know I recommended increasing the dose of Gabapentine up to 900mg daily.
I just wanted to know if she is still taking such dose?
In such case, I would recommend continuing taking Gabapentine at her actual dose for other 3 months.
After this period, if she is feeling OK and the pain is not coming back, you should discuss with her attending physician on the possibility of gradually stopping this therapy.
Hope to have been helpful!
Best regards!
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hi Dr morn.she takes gabapentine 300mg twice daily.the pain hasn't come bk in wks now.but she says it goes around her head.her physician recommended tegretol 1/2 tablet twice daily,tofranil 1 tablet only at night, Ativan1/2 tablet twice daily.this was before the ct scan though.so concerning the scan result, what do u recommend?
Brief Answer:
I recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information provided.
You should know that tegretol is an antiepileptic drug just like gabapentine, used to treat trigeminal neuralgia but has more adverse effects in elderly patients.
So, as her clinical situation is improved only with gabapentine 600 mg daily, I would recommend continuing this therapy for at least 3 months.
Regarding tofranil it is an antidepressant used to treat chronic headaches, sleep disorders or neuralgia.
Ativan is used to treat anxiety.
I don't think there is any need for this drugs as long as her clinical situation is improved.
I also recommend taking lifelong aspirin and a station as I recommended before.
Hope to have been helpful!
Best wishes!
Dr. Iliri
I recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information provided.
You should know that tegretol is an antiepileptic drug just like gabapentine, used to treat trigeminal neuralgia but has more adverse effects in elderly patients.
So, as her clinical situation is improved only with gabapentine 600 mg daily, I would recommend continuing this therapy for at least 3 months.
Regarding tofranil it is an antidepressant used to treat chronic headaches, sleep disorders or neuralgia.
Ativan is used to treat anxiety.
I don't think there is any need for this drugs as long as her clinical situation is improved.
I also recommend taking lifelong aspirin and a station as I recommended before.
Hope to have been helpful!
Best wishes!
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
Regarding the difficulty in raising her leg and her dizziness you should consult her with a neurologist for a careful physical examination.
The dizziness may be related to a low blood perfusion to the brain, related to her chronic small vessel disease or to vertebral arteries narrowing. That is why I would recommend also a Doppler ultrasound of the cervical arteries to examine the blood flow to the brain.
It may be a motor deficit related to brain ischemia.
Her CT scan shows changes related to the age and chronic small vessel disease, which means she has suffered different small strokes, maybe silent (without obvious symptomatology). This is why it is necessary to take a preventive therapy, in order to prevent from further vessel occlusion.
Based on the guidelines of stroke prevention, after being diagnosed with chronic vessel disease and brain ischemic events (like those detected on her CT scan), it is necessary to take daily aspirin and a statin. It is also necessary to control other possible cardiovascular risk factors like high blood pressure, diabetes, obezity, thyroid dysfunction etc.
For this reason it is necessary to closely monitor her blood pressure different times during the day (to be sure that those values are above 130/90mm Hg) and perform some tests:
-complete blood count
-thyroid hormone levels
-PCR, sedimentation rate
-kidney and liver function tests , to exclude other metabolic causes that may aggravate her situation.
Hope to have been helpful!
Please feel free to ask me directly at any time at the link below:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Greetings!
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello again!
Regarding the difficulty in raising her leg and her dizziness you should consult her with a neurologist for a careful physical examination.
The dizziness may be related to a low blood perfusion to the brain, related to her chronic small vessel disease or to vertebral arteries narrowing. That is why I would recommend also a Doppler ultrasound of the cervical arteries to examine the blood flow to the brain.
It may be a motor deficit related to brain ischemia.
Her CT scan shows changes related to the age and chronic small vessel disease, which means she has suffered different small strokes, maybe silent (without obvious symptomatology). This is why it is necessary to take a preventive therapy, in order to prevent from further vessel occlusion.
Based on the guidelines of stroke prevention, after being diagnosed with chronic vessel disease and brain ischemic events (like those detected on her CT scan), it is necessary to take daily aspirin and a statin. It is also necessary to control other possible cardiovascular risk factors like high blood pressure, diabetes, obezity, thyroid dysfunction etc.
For this reason it is necessary to closely monitor her blood pressure different times during the day (to be sure that those values are above 130/90mm Hg) and perform some tests:
-complete blood count
-thyroid hormone levels
-PCR, sedimentation rate
-kidney and liver function tests , to exclude other metabolic causes that may aggravate her situation.
Hope to have been helpful!
Please feel free to ask me directly at any time at the link below:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Greetings!
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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