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What Does The Following CT Scan Report Suggest?

Posted on Mon, 6 Oct 2014

Question: ct scan: old lacunar infarct. bilateral frontal lobe atrophy. calcified superior turbinate. deviated septum. bilateral ethmoid sinusitis. no mass lesion seen. biopsy: chronic inflammation no malignancy. (inside nose)....been on daily half hctz, one trimitazidine, one aspirin since the beginning of 2014. rivotril also .25 of 2 mg as needed. now im afraid that i have gastritis. my body aches all over. general weakness. tension type headache rivotril.

my problems are dizziness when i walk around, have stomach problems, tension-type headaches.

Answered by Dr. Suresh Heijebu (2 hours later)

Brief Answer:
Get serum electrolytes and CBP tested

Detailed Answer:
Hi Sir,

I have carefully read your query and understand your concern.

The cause of weakness in your case could be drug related particularly HCTZ.

This drug is a diuretic,that can cause salt and water loss from the body.

This can lead to occasional episodes of generalized weakness.

I advice you to get your serum electrolytes and complete blood picture/CBP tested to detect hypokalemia if any.

Correction of hypokalemia can lead to correction of weakness.

Consult your doctor for dose or drug modification of hctz,if its found to be responsible.

Drugs like Trimetazidine and Rivotril can cause gastrointestinal disturbances in the form of erosive gastritis with acid reflux symptoms.

This drugs need gastric protection from proton pump inhibitors like Pantoprazole D once daily before breakfast.

Note these drugs should be taken only under strict medical supervision.

Tension headache in your case is not related to any of your mentioned ct scan changes.

Tension headache can due to underlying stress/anxiety ,posture or depression.

Antiemetic/ analgesics are the main stay of treatment of TT headache.

Ibuprofen 600 mg twice a day along with metocloperamide are the drugs of choice in the management of TT headache.

These drugs should be taken only under strict medical supervision.

Relaxation techniques,cold packs,posture improvement,trigger point injections are the other methods to control this TT headaches.

I hope this info is useful to you,
Thank you

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Suresh Heijebu (27 minutes later)

are we sure or how strong can rivotril do damage? if aspirin is 10, how do you rate trimetazidine and rivotril?

Answered by Dr. Suresh Heijebu (7 minutes later)

Brief Answer:
Rating 7

Detailed Answer:
Hi

Rivotril and Trimetazidine can cause mild to moderate gastritis which can be reversible on stopping the drug,

I would like to rate these drugs with point 7.

Thank you

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Suresh Heijebu (8 minutes later)

aspirin reversible?

Answered by Dr. Suresh Heijebu (5 minutes later)

Brief Answer:
Reversible

Detailed Answer:
Hi,
Yes even aspirin is reversible,but it takes a longer time of 7-14 days XXXXXXX to recover.
Thank you

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Suresh Heijebu (47 minutes later)

k. will leave line open.

Answered by Dr. Suresh Heijebu (13 minutes later)

Brief Answer:
You welcome sir

Detailed Answer:
Hi Sir

I Wish and expect your complete recovery .
please post your queries,if any
Thank you

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Suresh Heijebu (14 hours later)

can my calcified turbinate or sinusitis cause headaches? 3 hours mornings none.

Answered by Dr. Suresh Heijebu (7 hours later)

Brief Answer:
Swollen turbinates lead to headache

Detailed Answer:
HI

Hypertrophied or calcified turbinate can readily cause pansinusitis(inflammation of all sinuses) leading to tight band like boring headaches variable throughout the day,but are more predominant in the early day particularly morning,sometimes termed as office headaches.

swollen turbinate presses itself on to the local nerves leading to headache.

Occasionally it takes time or the accumulated fluid within the sinus due to blockade created by the swollen turbinate to the free flow,this can lead to headache free interval.

Turbinectomy can completely resolve such symptoms.

Thank you

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Suresh Heijebu (16 hours later)

chinese natural herb med ok for sinusitis?

Answered by Dr. Suresh Heijebu (12 hours later)

Brief Answer:
FESS is curative

Detailed Answer:
HI,

Chinese herbs can reduce the severity of symptoms but can't offer total cure.

I advice you to have a non contrast CT scan of your paranasal sinuses to determine the extent of involvement followed by FESS-functional endoscopic sinus surgery.

This procedure can offer permanent cure.

Thank you

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Suresh Heijebu (5 hours later)

low money for suggestions. is there another way? it is not actually headache but every 6th hour head becomes heavy and hard to walk normally. then i take rivotril. there is cycle. aura comes and rivotril not yet taken temporal and upper neck pains. moderate to severe dizziness.

Answered by Dr. Suresh Heijebu (51 minutes later)

Brief Answer:
CT brain plus CT pns is required to decide further

Detailed Answer:
Hi

I have completely understood the cycle of your symptoms .

This cycle highly goes in favor of chronic rhinosinusitis.

I am extremely sorry to say that no other therapy exists apart from the one i mentioned.

The heaviness in your head could be due to retention of blocked mucous within the sinuses.

This brings on recurrent headaches.

At this I request you to get the Non contrast CT scan of your paranasal sinuses to detect changes of sinusitis if any.

This is the basic mandate.

The further course of treatment can be discussed later based on the report CT-PNS.

Temporal and neck pains can be related to your sinusitis problem.

Please note that chronic sinusitis has to treated early ,if not it turns resistant to therapy leading various complications within your brain.

Thank you

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Raju A.T