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What Does This CT Scan Report For Severe Headache Indicate?

Posted on Wed, 11 May 2016

Question: I am a 55 year old diabetic,hypertensive man and was admitted to hospital with history of sudden onset severe headache starting from the back of the scalp on july 2015.Clinically there was no focal neurodeficit.Considering the thunderclap headache,its differentials were thought of and imaging was done accordingly.CT scan brain revealed subarachnoid haemorrhage.CT angiogram did not show any aneurysm or AVM and so I was kept under conservative medical management.I was finally diagnosed with Hypothyroidism,Diabetes Mellitus Type 2 and Perimesencephalic Subarchnoid Haemorrhage.DOCTORS TOLD THAT IT WAS A MILD STROKE.I took Nimodip 60 mg 1 tab 4 hourly for 3 weeks,Clonazepam 0.25 mg 1 tab once daily at bed time,Ganaton 50 mg 1 tab thrice daily for 2 weeks. My height is 5 ft and Weight was 80 kg.
Now my weight is 72 kg.Now I am taking Glycomet SR 500 twice daily and Telma 40 once daily.I feel tired everytime.My blood pressure is 118/63.My Venous Plasma Glucose Fasting is 99mg/dl and PP is 131 mg/dl.The HbA1c is 5.9% .I had a CT Scan of Brain.My findings are-Posterior fossa structures are normal with middle 4th ventricle.Basal cisterns and sylvian fissures are prominent.Supratentorial ventricles are prominent with the septum in the midline.No focal altered density is seen in brain parenchyma including deep gray nuclei.Cortical sulci are prominent.Sella and parasellar regions appear normal.The Impression is-Age Related Cerebral Atrophy.
Should I continue the same medications?I am unable to visit my physician due to my busy schedule.Is the report dangerous?Is there any harm if I contact him after 1 month?What things should I follow?

Answered by Dr. Ajay Panwar (2 hours later)

Brief Answer:
This report has nothing serious.

Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I have gone through your detailed medical history and read your latest CT report.
This CT scan has nothing serious to mention.Prominent basal cisterns and sylvian fissures along with prominent sulci and ventricles are suggestive of 'Age related cerebral atrophy'.This is a normal physiological phenomenon with increasing age.This is not a disease.
So,for now,
1)You can continue the same medicines till you visit your physician.
2)As I said,report is not dangerous.
3)You can very well,contact your physician after a month.There is no such urgency over here.
4)Proper control of your Diabetes and Hypertension.Avoid strenuous exercises and lifting heavy weights.

Hope this helps.If you have any further questions,I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (21 hours later)

One more question,Doctor.As I am a bank employee,I have to work 8 hours daily in front of computer and my job is very stressful.I also have to travel 1 hour by bus to my office.Are these things harmful for me?My physician also prescribed Feliz-S-10.But I don't take it because I feel drowsiness for the whole day after taking this medicine?Is it okay if I don't take it?

Answered by Dr. Ajay Panwar (17 hours later)

Brief Answer:
You may not take it,if you don't have much problem.

Detailed Answer:
Hi XXXXX,
Thanks for being in follow-up.

These things are a part of your professional life.So,you can't reduce them to an absolute zero but try to minimize stress as much as possible.

If you feel fine without Feliz-S,you may not take it.There is no harm in discontinuing.

If you have any further questions,I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar