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Suggest Ways To Manage Dementia

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Posted on Fri, 10 Jun 2016
Question: Hi,
My Father is suffering from forgetting things. My Father's age is 63. He is also having the Blood Sugar problem. Preliminary we had gone through the treatment under a neuro psychiatrist and gave some medicine and which has also been given in the attached file. We had also gone through some test like CT Scan, MRI which is also enclosed.
The followings are the questions:
1. Impression of BRAIN MRI : Small vessel ischaemic changes & Cerebro -Cerebeller degenerative changes . What does it mean and what is the impact of this ?
2. Is there any surgical matter is related to this ?
3. Is there any life threat related to this ?
4. Need your valuable suggestion for way forward.
doctor
Answered by Dr. Neeraj Kumar (18 minutes later)
Brief Answer:
Proper treatment for dementia is required

Detailed Answer:
Hello XXXX,
I have gone through your question and understand your concerns.
The Mri is showing age related effects of changes on blood vessels of brain accelerated by hypertension and diabetes.
Dementia is usually age related and in cases with hypertension and diabetes earlier presentation is common. No surgical treatment is available in case of your father.
There is no life threatening condition, but it is not curable and progress with time. The available drugs may slow the process.
All drugs prescribed are good for the present situation.
Follow up with a neurologist will be beneficial in long term.
Proper control of blood pressure and hypertension is necessary.
Some invesytigations for dementia can be done like thyroid profile, vitamin B12 levels, renal and liver function tests.
Hope you found the answer helpful.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Neeraj Kumar (17 hours later)
sir
we discussed with another doctor yesterday after MRI he told that some fluid is storing in his brain n he need to be operated immediately.He told us that one pipe will be installed which will bypass the fluid flow to the stomach.

1. What does this mean?
2. what will be the impact of this operation?
3. please suggest what should we do.
4. shall we visit nimhans hospital bangalore?
doctor
Answered by Dr. Neeraj Kumar (4 hours later)
Brief Answer:
Get consultation from NIMHANS too

Detailed Answer:
Hello,
I have gone through your question.
The operation advised is ventricular peritoneal shunt which bypass the csf from ventricles into the abdominal space.
The benefit is there if it is done in right cases like normal pressure hydrocephalus or obstructive hydrocephalus.
In Mri no such suggestion is there and only clinical examination will be helpful.
Since it is not an urgent operation you can very well consult NIMHANS to get true advice. If same is advised there also you can go ahead with surgery.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Deepak
doctor
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Follow up: Dr. Neeraj Kumar (22 hours later)
sir
From few days he is acting little bit differently like he always thinks that we are ignoring him or treating differently but sir we are taking very good care of him anmd try him to believe that we are family and we are always with him.He always cry in alone and tells something that has not been happened like hallucinating.
1. please suggest what should we do now?
2. we will go to NIMHANS but now what should we do to make him believe that we r family and we are with you only.
doctor
Answered by Dr. Neeraj Kumar (1 hour later)
Brief Answer:
Take decision according to patient condition

Detailed Answer:
Hello dear,
Behavioral changes can occur very well in brain degeneration, dementia or normal pressure hydrocephalous.
You can get some medications like quietiapine for such symptoms.
If you feel the surgical advise is from a competent doctor then go ahead with surgery else wait for NIMHANS consultation.
MRI report is not showing any such feature.
Treating doctor is the best judge of clinical condition of patient as he as advantage of examining the patient.
If condition is deteriorating fast and NIMHANS consultation is delayed then go for surgery.
Hope you found the answer helpful.
Regards
Dr N Kumar
neurologist
Above answer was peer-reviewed by : Dr. Deepak
doctor
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Follow up: Dr. Neeraj Kumar (3 hours later)
Thank you sir for your valuable advice..
We are visiting NIMHANS on 15th of this month.
doctor
Answered by Dr. Neeraj Kumar (10 hours later)
Brief Answer:
Best wishes

Detailed Answer:
Hello dear,
Best wishes for good health.
Praying for better treatment and recovery.
Dr N Kumar
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2259 Questions

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Suggest Ways To Manage Dementia

Brief Answer: Proper treatment for dementia is required Detailed Answer: Hello XXXX, I have gone through your question and understand your concerns. The Mri is showing age related effects of changes on blood vessels of brain accelerated by hypertension and diabetes. Dementia is usually age related and in cases with hypertension and diabetes earlier presentation is common. No surgical treatment is available in case of your father. There is no life threatening condition, but it is not curable and progress with time. The available drugs may slow the process. All drugs prescribed are good for the present situation. Follow up with a neurologist will be beneficial in long term. Proper control of blood pressure and hypertension is necessary. Some invesytigations for dementia can be done like thyroid profile, vitamin B12 levels, renal and liver function tests. Hope you found the answer helpful. Regards Dr N Kumar Neurologist