Friday, May 15, 2009

Kesinambungan Kisah Kesakitan Aku!!

Kenape aku bg title kesinambungan??
~This for those yg sentiasa mengikuti perkembangan aku especially kwn2 yg ambil berat psl aku.Hope korg xmarah aku lg lps nie sbb xbg tau korg yg aku masuk hospital.Thanx kwn2!!~

Sbb aku nk citer psl ape yg baru diberitahu oleh Mister Nujaimin, Pakar Radiosurgery Hospital Kuala Lumpur pada 29 April 2009 yg sudah. Kate Dr. Nujaimin, mse nie kite xnmpk lg kesan radiosurgery hari tue. But, every month kite akn buat medical checkup and every six month kite akn jumpe utk buat rawatan. Kte Dr lg, radiosurgery yg kite buat tahun lepas ada kesannyer. Kesan positif, salur darah tue akn mati dan yg xbest didengar adalah kesan negatif di mana kawasan otak yg mengalami laser hari tue akn mula mereput. Agk2nyer kn, ape akn jadi kalau bahagian tue mereput?? Pada aku, ianya satu tanda tanya yg sgt merunsingkan. Dr. cakap " kamu kene ingat yg potensi untuk dapat pendarahan ke-2 masih boleh berlaku.Ingat jangan fikir" lebih kurang macam tue la Dr. Nujaimin ckp. Apepn, dlm 6 bulan dari sekarang, aku sekali lg akan melakukan Magnetic Resonance Imaging (MRI). Bagi aku, prosedur biasa sbb dh byk kali buat. Rawatan nie mungkin akan mengambil masa selame 10 tahun lg untuk pastikan otak aku betul2 bersih dari AVM.So, dat's it. Next story, wait until six month.. Chow~
{AVM Patient's}

Friday, May 8, 2009

WHAT IS AVM??

Cerebral arteriovenous malformation (AVM) is a malformed collection of blood vessels within the brain, characterized by tangle(s) of veins and arteries. While an arteriovenous malformation can occur elsewhere in the body, this article discusses malformations found in the brain.

Symptoms
The most frequently observed problems related to an AVM are
headaches and seizures. These symptoms vary from extremely mild neurological events (e.g. unusual sensations) to uncontrolled grand mal seizures. Moreover, AVMs in certain critical locations may stop the circulation of the cerebrospinal fluid, causing accumulation of the fluid within the skull and giving rise to a clinical condition called hydrocephalus.
Symptoms of bleeding within the brain (
intracranial hemorrhage) include loss of consciousness, sudden and severe headache, nausea, vomiting, incontinence, and blurred vision, amongst others. Minor bleeding can occur with no noticeable symptoms. A stiff neck can occur as the result of increased pressure within the skull and irritation of the meninges. Impairments caused by local brain tissue damage on the bleed site are possible, including seizure, one-sided weakness (hemiparesis), a loss of touch sensation on one side of the body and deficits in language processing (aphasia). A variety of other symptoms can accompany this type of cerebrovascular accident.
Generally, intense headache, perhaps coincident with seizure or loss of bodily consciousness, is the first indication of a cerebral AVM. Estimates of the number of AVM-afflicted people in the United States range from 0.1% to 0.001% of the population.



Diagnosis
An AVM diagnosis is established by
neuroimaging studies. A computed tomography scan of the head (head CT) is usually performed—this can reveal the site of the bleed. More detailed pictures of the tangle of blood vessels that compose an AVM can be obtained by using radioactive reagents injected into the blood stream, then observed using a fluoroscope or Magnetic Resonance Imaging (MRI). A spinal tap (lumbar puncture) can be used to examine spinal fluid for red blood cells; this condition is indicative of leakage of blood from the bleeding vessels into the subarachnoid space. The best images of an AVM are obtained through cerebral angiography. This procedure involves using a catheter, threaded through an artery up to the head, to deliver a contrast agent into the AVM. As the contrast agent flows through the AVM structure, a sequence of X-ray images can be obtained to ascertain the size, shape and extent of that structure.


Treatment
The treatment in the case of sudden bleeding is focused on restoration of vital function. Anticonvulsant medications such as
phenytoin are often used to control seizure; medications or procedures may be employed to relieve intracranial pressure. Eventually, curative treatment may be required to prevent recurrent hemorrhage. However, any type of intervention may also carry a risk of creating a neurological deficit.
In the U.S., surgical removal of the blood vessels involved (
craniotomy) is the preferred curative treatment for most types of AVM. While this surgery results in an immediate, complete removal of the AVM, risks exist depending on the size and the location of the malformation.
Radiation treatment (
radiosurgery) has been widely used on smaller AVMs with considerable success. The Gamma Knife, developed by Swedish physician Lars Leksell, is one apparatus used in radiosurgery to precisely apply a controlled radiation dosage to the volume of the brain occupied by the AVM. While this treatment is non-invasive, two to three years may pass before the complete effects are known. Complete occlusion of the AVM may or may not occur, and 8%-10% of patients develop long term neurological symptoms after radiation.[citation needed]
Embolization, that is, occlusion of blood vessels with coils or particles or glue introduced by a radiographically guided catheter, is frequently used as an adjunct to either surgery or radiation treatment. However, embolization alone is rarely successful in completely blocking blood flow through the AVM.
The benefit of invasive treatment for unruptured AVMs has never been proven, as the risk of intervention may be as high as the spontaneous bleeding risk. An international study is currently under way to determine the best therapy for patients with unruptured AVMs (ARUBA—A Randomized Trial of Unruptured Brain AVMs.