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What Precautions Should Be Taken When Suffering From Defects In Spine?
Question: Sir,
1. i have a problem of unusual feeling when i m walking(mostly) since last 25-30 days, i feel that my head movement is not synchronised with my body movement. so i have got MRI of brain and spine screening done(report attached), my blood tests are mormal(hb, sugar fasting &PP, WBC,RBC etc). i have my ears tested manualy, The ENT Sp. says no problem with ear. i just want to know what could be the problem.
my mri report say's A) Prominent virchow XXXXXXX space in the right capsuloganglionic region'
B)The screening intraclanial angiogram reveals- hypoplastic right vertiberal artery
C)The screening study through ihe entire splne reveals _
(i)straightening of cervical spine '
(ii)posterior bulge of the C4-5 and C5-6 intervenebral discs indenting antenor subarachnoid space.
(iii) Posterior amular tear of the L5-s I intervertebral disc
2. (a) i feel as if brain is delayed to catch up with my body movement, as i step my left foot forward the brain follows later and by the time i have my right foot ahead.so due to this difference in movement i start feeling something between consious and unconsious.
(b) i have some stiffness of neck as well where bending of neck backward is very painful.( report MRI refers)
3. my job involves a bit of stress so to see if it works my neuro has adviced me to take Benfomet plus and Eliwel 10. It has been 3 days since i started this medication but nill benifits till now.
4. I m 36 years old Male serving onboard ship
5. Sir i need to know the following
(a) Does the points revealed in MRI have any connection with my problem.
(b) what precautions shall i take for the defects in spine that i have.
1. i have a problem of unusual feeling when i m walking(mostly) since last 25-30 days, i feel that my head movement is not synchronised with my body movement. so i have got MRI of brain and spine screening done(report attached), my blood tests are mormal(hb, sugar fasting &PP, WBC,RBC etc). i have my ears tested manualy, The ENT Sp. says no problem with ear. i just want to know what could be the problem.
my mri report say's A) Prominent virchow XXXXXXX space in the right capsuloganglionic region'
B)The screening intraclanial angiogram reveals- hypoplastic right vertiberal artery
C)The screening study through ihe entire splne reveals _
(i)straightening of cervical spine '
(ii)posterior bulge of the C4-5 and C5-6 intervenebral discs indenting antenor subarachnoid space.
(iii) Posterior amular tear of the L5-s I intervertebral disc
2. (a) i feel as if brain is delayed to catch up with my body movement, as i step my left foot forward the brain follows later and by the time i have my right foot ahead.so due to this difference in movement i start feeling something between consious and unconsious.
(b) i have some stiffness of neck as well where bending of neck backward is very painful.( report MRI refers)
3. my job involves a bit of stress so to see if it works my neuro has adviced me to take Benfomet plus and Eliwel 10. It has been 3 days since i started this medication but nill benifits till now.
4. I m 36 years old Male serving onboard ship
5. Sir i need to know the following
(a) Does the points revealed in MRI have any connection with my problem.
(b) what precautions shall i take for the defects in spine that i have.
Brief Answer:
Please avoid lifting weight and fast neck movement
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query.
What I understand is that you got a MRI brain and whole spine screening done for your symptoms.
1. Prominent Virchow XXXXXXX space in right capusoganglionic region is a mention of a probably normal appearance if less than 2 mm. Since no further remark has been made, I consider this as an observation and not clinically significant in your case.
2. Hypoplastic right vertebral artery is seen in 2 - 6 % of people and can be considered a congenital variation. Since it supplies blood to the smaller brain, it can cause problems mostly when the blood supply through the main supply is reduced. Other than this it can lead to regional hypoperfusion and complex neurovascular consequences which correspond to vestibular neuronitis and migraine pathogenesis.
This has not occurred in you so there is no need to worry.
3. Straightening of cervical spine with posterior bulge of the C 4-5 and C 5-6 intervertebral discs indenting anterior subarachnoid space is an early degenerative condition and shows that the discs between bones in your neck region are mildly displaced. However no serious consequences are noted.
4. Posterior annular tear of the L 5- S 1 intervertebral disc is degeneration of a disc in the lower back and can also be attributed to early degenerative changes in the absence of any back injury.
5. The feeling of consciousness and unconsciousness when stepping forward is which might cause your symptoms not a direct manifestation of the hypoplastic right vertebral artery and there is no evidence of damage to any part of your brain. but keeping this in mid is important if your symptoms progress or you develop new symptoms. This needs to be followed up with your neurologist.
6. Neck stiffness is due to disc changes at levels C4-5 and C5-6 and physiotherapy might help. Please avoid lifting heavy weights using your hands and refrain from sudden neck movements.
7. Benfomet plus is a medication that helps neuro enhancers and help the nerves to function better. Eliwel 10 is Amitriptyline and is given to treat nerve-related pain, to prevent migraine headaches and in depression.
Both the medications will show effects after taking them for at least 15 days.
The relation between MRI findings and your symptoms are explained above. You can continue your job in ship but avoid sudden neck movements and lifting heavy weight above your head. Try not to use pillow when you sleep at night. Please do physiotherapy for neck.
Hope your query is answered.
Please write back if you have any doubts.
Regards,
Dr.Vivek
Please avoid lifting weight and fast neck movement
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query.
What I understand is that you got a MRI brain and whole spine screening done for your symptoms.
1. Prominent Virchow XXXXXXX space in right capusoganglionic region is a mention of a probably normal appearance if less than 2 mm. Since no further remark has been made, I consider this as an observation and not clinically significant in your case.
2. Hypoplastic right vertebral artery is seen in 2 - 6 % of people and can be considered a congenital variation. Since it supplies blood to the smaller brain, it can cause problems mostly when the blood supply through the main supply is reduced. Other than this it can lead to regional hypoperfusion and complex neurovascular consequences which correspond to vestibular neuronitis and migraine pathogenesis.
This has not occurred in you so there is no need to worry.
3. Straightening of cervical spine with posterior bulge of the C 4-5 and C 5-6 intervertebral discs indenting anterior subarachnoid space is an early degenerative condition and shows that the discs between bones in your neck region are mildly displaced. However no serious consequences are noted.
4. Posterior annular tear of the L 5- S 1 intervertebral disc is degeneration of a disc in the lower back and can also be attributed to early degenerative changes in the absence of any back injury.
5. The feeling of consciousness and unconsciousness when stepping forward is which might cause your symptoms not a direct manifestation of the hypoplastic right vertebral artery and there is no evidence of damage to any part of your brain. but keeping this in mid is important if your symptoms progress or you develop new symptoms. This needs to be followed up with your neurologist.
6. Neck stiffness is due to disc changes at levels C4-5 and C5-6 and physiotherapy might help. Please avoid lifting heavy weights using your hands and refrain from sudden neck movements.
7. Benfomet plus is a medication that helps neuro enhancers and help the nerves to function better. Eliwel 10 is Amitriptyline and is given to treat nerve-related pain, to prevent migraine headaches and in depression.
Both the medications will show effects after taking them for at least 15 days.
The relation between MRI findings and your symptoms are explained above. You can continue your job in ship but avoid sudden neck movements and lifting heavy weight above your head. Try not to use pillow when you sleep at night. Please do physiotherapy for neck.
Hope your query is answered.
Please write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Shanthi.E
sir i m quite satisfied by your answer, i have a small query , what could be the reason for my problem of vertigo if everything else is fine? Also i have read in wikipedia (symptoms of dilated VR spaces where positional vertigo is also a symptom, is it applicable in my case)
Brief Answer:
Small VR space less likely to cause vertigo
Detailed Answer:
Hi XXXX
Thanks for writing back with an update.
Technically positional vertigo is to be diagnosed clinically after doing tests like electronystagmography and clinical examination by ENT specialist is important. Vertigo is a difficult symptom to elicit and as you see from our earlier discussion, hypoplastic right vertebral artery and large VR spaces both can cause vertigo. As measurement of your VR space is not mentioned, I think it must be small. The important point is that you are having the dizziness only since 25 - 30 days and this may not be in favor of a VR space. Not much can be commented on the hypoplastic vertebral artery at the moment but future attacks need to be clearly followed because hypoplastic vertebral artery can be a risk factor for developing vertigo when you have stress. I suggest you decrease stress at your work and keep note of dizziness episodes.
Hope your query is answered.
Please write back if you have any doubts.
Regards,
Dr.Vivek
Small VR space less likely to cause vertigo
Detailed Answer:
Hi XXXX
Thanks for writing back with an update.
Technically positional vertigo is to be diagnosed clinically after doing tests like electronystagmography and clinical examination by ENT specialist is important. Vertigo is a difficult symptom to elicit and as you see from our earlier discussion, hypoplastic right vertebral artery and large VR spaces both can cause vertigo. As measurement of your VR space is not mentioned, I think it must be small. The important point is that you are having the dizziness only since 25 - 30 days and this may not be in favor of a VR space. Not much can be commented on the hypoplastic vertebral artery at the moment but future attacks need to be clearly followed because hypoplastic vertebral artery can be a risk factor for developing vertigo when you have stress. I suggest you decrease stress at your work and keep note of dizziness episodes.
Hope your query is answered.
Please write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
sir i hope this is the last one from my side
please specify do's and don't for finding of MRI (for brain and for spine as well)
thanx
please specify do's and don't for finding of MRI (for brain and for spine as well)
thanx
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
I suggest that you please continue taking the medications. Do physiotherapy and avoid turning head suddenly and lifting more than 5 kg above your head. At night please sleep on a hard surface and avoid using a pillow.
For the brain, you dont have to do anything but if you feel dizziness then please take rest for sometime.
Please consult a doctor if you have any dizziness and severe headache for more than a day
Hope your query is answered.
Please write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
I suggest that you please continue taking the medications. Do physiotherapy and avoid turning head suddenly and lifting more than 5 kg above your head. At night please sleep on a hard surface and avoid using a pillow.
For the brain, you dont have to do anything but if you feel dizziness then please take rest for sometime.
Please consult a doctor if you have any dizziness and severe headache for more than a day
Hope your query is answered.
Please write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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