Diagnosis To determine the most appropriate treatment for your stroke, your emergency team needs to evaluate the type of stroke you're having and the areas of your brain affected by the stroke. They also need to rule out other possible causes of your symptoms, such as a brain tumor or a drug reaction. Your doctor may use several tests to determine your risk of stroke, including: Stroke consultation Stroke consultation Stroke consultation at Mayo Clinic Brain tissue damaged by stroke CT scan of brain tissue damaged by stroke Cerebral angiogram Cerebral angiogram Physical examination. Your doctor will ask you or a family member what symptoms you've been having, when they started and what you were doing when they began. Your doctor then will evaluate whether these symptoms are still present. Your doctor will want to know what medications you take and whether you have experienced any head injuries. You'll be asked about your personal and family history of heart disease, transient ischemic attack and stroke. Your doctor will check your blood pressure and use a stethoscope to listen to your heart and to listen for a whooshing sound (bruit) over your neck (carotid) arteries, which may indicate atherosclerosis. Your doctor may also use an ophthalmoscope to check for signs of tiny cholesterol crystals or clots in the blood vessels at the back of your eyes. Blood tests. You may have several blood tests, which tell your care team how fast your blood clots, whether your blood sugar is abnormally high or low, whether critical blood chemicals are out of balance, or whether you may have an infection. Managing your blood's clotting time and levels of sugar and other key chemicals will be part of your stroke care. Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create a detailed image of your brain. A CT scan can show a hemorrhage, tumor, stroke and other conditions. Doctors may inject a dye into your bloodstream to view your blood vessels in your neck and brain in greater detail (computerized tomography angiography). There are different types of CT scans that your doctor may use depending on your situation. Magnetic resonance imaging (MRI). An MRI uses powerful radio waves and magnets to create a detailed view of your brain. An MRI can detect brain tissue damaged by an ischemic stroke and brain hemorrhages. Your doctor may inject a dye into a blood vessel to view the arteries and veins and highlight blood flow (magnetic resonance angiography, or magnetic resonance venography). Carotid ultrasound. In this test, sound waves create detailed images of the inside of the carotid arteries in your neck. This test shows buildup of fatty deposits (plaques) and blood flow in your carotid arteries. Cerebral angiogram. In this test, your doctor inserts a thin, flexible tube (catheter) through a small incision, usually in your groin, and guides it through your major arteries and into your carotid or vertebral artery. Then your doctor injects a dye into your blood vessels to make them visible under X-ray imaging. This procedure gives a detailed view of arteries in your brain and neck. Echocardiogram. An echocardiogram uses sound waves to create detailed images of your heart. An echocardiogram can find a source of clots in your heart that may have traveled from your heart to your brain and caused your stroke. You may have a transesophageal echocardiogram. In this test, your doctor inserts a flexible tube with a small device (transducer) attached into your throat and down into the tube that connects the back of your mouth to your stomach (esophagus). Because your esophagus is directly behind your heart, a transesophageal echocardiogram can create clear, detailed ultrasound images of your heart and any blood clots. Treatment Emergency treatment for stroke depends on whether you're having an ischemic stroke blocking an artery — the most common kind — or a hemorrhagic stroke that involves bleeding into the brain. Ischemic stroke To treat an ischemic stroke, doctors must quickly restore blood flow to your brain. Emergency treatment with medications. Therapy with clot-busting drugs must start within 4.5 hours if they are given into the vein — and the sooner, the better. Quick treatment not only improves your chances of survival but also may reduce complications. You may be given: Intravenous injection of tissue plasminogen activator (tPA). This injection of recombinant tissue plasminogen activator (tPA), also called alteplase, is considered the gold standard treatment for ischemic stroke. An injection of tPA is usually given through a vein in the arm. This potent clot-busting drug ideally is given within three hours. In some instances, tPA can be given up to 4.5 hours after stroke symptoms begin. This drug restores blood flow by dissolving the blood clot causing your stroke, and it may help people who have had strokes recover more fully. Your doctor will consider certain risks, such as potential bleeding in the brain, to determine if tPA is appropriate for you. Emergency endovascular procedures. Doctors sometimes treat ischemic strokes with procedures performed directly inside the blocked blood vessel. These procedures must be performed as soon as possible, depending on features of the blood clot: Medications delivered directly to the brain. Doctors may insert a long, thin tube (catheter) through an artery in your groin and thread it to your brain to deliver tPA directly into the area where the stroke is occurring. This is called intra-arterial thrombolysis. The time window for this treatment is somewhat longer than for intravenous tPA, but is still limited. Removing the clot with a stent retriever. Doctors may use a catheter to maneuver a device into the blocked blood vessel in your brain and trap and remove the clot. This procedure is particularly beneficial for people with large clots that can't be completely dissolved with tPA, though this procedure is often performed in combination with intravenous tPA. Several large and recent studies suggest that, depending on the location of the clot and other factors, endovascular therapy might be the most effective treatment. Endovascular therapy has been shown to significantly improve outcomes and reduce long-term disability after ischemic stroke. Other procedures. To decrease your risk of having another stroke or transient ischemic attack, your doctor may recommend a procedure to open up an artery that's narrowed by plaque. Doctors sometimes recommend the following procedures to prevent a stroke. Options will vary depending on your situation: Carotid endarterectomy. In a carotid endarterectomy, a surgeon removes plaques from arteries that run along each side of your neck to your brain (carotid arteries). In this procedure, your surgeon makes an incision along the front of your neck, opens your carotid artery and removes plaque that blocks the carotid artery. Your surgeon then repairs the artery with stitches or a patch made from a vein or artificial material (graft). The procedure may reduce your risk of ischemic stroke. However, a carotid endarterectomy also involves risks, especially for people with heart disease or other medical conditions. Angioplasty and stents. In an angioplasty, a surgeon usually accesses your carotid arteries through an artery in your groin. Here, your surgeon can gently and safely navigate to the carotid arteries in your neck. A balloon is then inflated to expand the narrowed artery. Then a stent can be inserted to support the opened artery. Hemorrhagic stroke Emergency treatment of hemorrhagic stroke focuses on controlling your bleeding and reducing pressure in your brain. You might also need surgery to help reduce future risk. Emergency measures. If you take warfarin (Coumadin, Jantoven) or anti-platelet drugs such as clopidogrel (Plavix) to prevent blood clots, you may be given drugs or transfusions of blood products to counteract the blood thinners' effects. You may also be given drugs to lower pressure in your brain (intracranial pressure), lower your blood pressure, prevent vasospasm or prevent seizures. Once the bleeding in your brain stops, treatment usually involves supportive medical care while your body absorbs the blood. Healing is similar to what happens while a bad bruise goes away. If the area of bleeding is large, your doctor may perform surgery to remove the blood and relieve pressure on your brain. Surgical blood vessel repair. Surgery may be used to repair blood vessel abnormalities associated with hemorrhagic strokes. Your doctor may recommend one of these procedures after a stroke or if an aneurysm or arteriovenous malformation (AVM) or other type of vascular malformation caused your hemorrhagic stroke: Surgical clipping. A surgeon places a tiny clamp at the base of the aneurysm, to stop blood flow to it. This clamp can keep the aneurysm from bursting, or it can prevent re-bleeding of an aneurysm that has recently hemorrhaged. Coiling (endovascular embolization). A surgeon inserts a catheter into an artery in your groin and guides it to your brain using X-ray imaging. Tiny detachable coils are guided into the aneurysm (aneurysm coiling). The coils fill the aneurysm, which blocks blood flow into the aneurysm and causes the blood to clot. Surgical AVM removal. Surgeons may remove a smaller AVM if it's located in an accessible area of your brain, to eliminate the risk of rupture and lower the risk of hemorrhagic stroke. However, it's not always possible to remove an AVM if its removal would cause too large a reduction in brain function, or if it's large or located deep within your brain. Stereotactic radiosurgery. Using multiple beams of highly focused radiation, stereotactic radiosurgery is an advanced minimally invasive treatment used to repair vascular malformations. Stroke recovery and rehabilitation Brain hemisphere connections Brain hemisphere connections After emergency treatment, stroke care focuses on helping you recover as much function as possible and return to independent living. The impact of your stroke depends on the area of the brain involved and the amount of tissue damaged. If your stroke affected the right side of your brain, your movement and sensation on the left side of your body may be affected. If your stroke damaged the brain tissue on the left side of your brain, your movement and sensation on the right side of your body may be affected. Brain damage to the left side of your brain may cause speech and language disorders. In addition, if you've had a stroke, you may have problems with breathing, swallowing, balancing and vision. Most stroke survivors receive treatment in a rehabilitation program. Your doctor will recommend the most rigorous therapy program you can handle based on your age, overall health and degree of disability from your stroke. Your doctor will take into consideration your lifestyle, interests and priorities, and the availability of family members or other caregivers. Your rehabilitation program may begin before you leave the hospital. After discharge, you might continue your program in a rehabilitation unit of the same hospital, another rehabilitation unit or skilled nursing facility, an outpatient unit, or your home. Every person's stroke recovery is different. Depending on your condition, your treatment team may include: Doctor trained in brain conditions (neurologist) Rehabilitation doctor (physiatrist) Nurse Dietitian Physical therapist Occupational therapist Recreational therapist Speech pathologist Social worker Case manager Psychologist or psychiatrist Chaplain Speech therapy session Speech therapy is often a part of stroke rehabilitation. Treatment outcomes One way to evaluate the care of patients diagnosed with stroke is to look at the percentage of patients receiving the timely and effective care measures that are appropriate. The goal is 100 percent. The graphs below display the percentage of eligible Mayo Clinic patients diagnosed with stroke receiving all of the appropriate care measures.

Root canal is a treatment to repair and save a badly damaged or infected tooth instead of removing it. The term "root canal" comes from cleaning of the canals inside a tooth's root. Decades ago, root canal treatments often were painful. With dental advances and local anesthetics, most people have little if any pain with a root canal. In fact, it's probably more painful living with a decayed tooth. Root canal alternatives include extracting the damaged tooth and replacing it with a dental implant, bridge or removable partial denture.

Acne can form several types of skin blemish, each with a distinct appearance and symptoms. Most minor acne blemishes respond to at-home care and over-the-counter medications. However, people with severe or long-term acne should speak with a doctor or dermatologist. Acne affects around 80 percent of adolescents and young adults. About 40–50 million Americans have acne at any given time. The following are common types of blemish associated with acne: whiteheads blackheads pustules, which are commonly called pimples papules cysts nodules Each type of acne lesion requires a different treatment. Receiving prompt, correct treatment can reduce the risk of long-term skin complications, such as dark spots and scarring. Acne blemishes fall into two categories, depending on whether or not they cause inflammation of the surrounding skin. Whiteheads Whiteheads Blackheads blackheads are pockets of oxidized melanin on the surface of the skin Papules Papules Pustules (pimples) Pustules (pimples) Nodules Nodules Cysts pus in a cyst 1of6 Noninflammatory acne types Whiteheads and blackheads are types of noninflammatory acne lesion. They are the least severe forms of acne. Noninflammatory blemishes usually do not cause swelling and are not very painful. Whiteheads The medical term for whiteheads is closed comedones. These are small, whitish or flesh-colored spots or bumps. They usually have a white, circular center surrounded by a red halo. A hair will sometimes emerge from the center of a whitehead, or it may appear to be trapped within the blemish. The skin around a whitehead may appear to be tight or wrinkled, especially when the whitehead is large or especially raised. ADVERTISEMENT Approved NSCLC Treatment - HCP Info & Resources Request A Rep & Discover A Therapy For Stage III NSCLC. www.stage-iii-nsclc-therapy.com Whiteheads typically do not cause scarring. Blackheads Blackheads are also called open comedones. They are small, black or dark-colored spots that may appear as slightly raised bumps. The skin around a blackhead usually appears normal, while the center of the blackhead is darker than the surrounding area. The coloration is not a result of trapped dirt. Blackheads are simply whiteheads that have opened and widened. When the contents of a whitehead are exposed to air, they darken. Treatment options Many over-the-counter rinses, moisturizers, gels, toners, and creams can treat noninflammatory acne blemishes. They often contain a mix of active ingredients. The following ingredients in over-the-counter treatments can help to break down whiteheads and blackheads: benzoyl peroxide salicylic acid sulfur resorcinol Also, several home remedies and lifestyle changes can help to reduce most minor-to-mild forms of noninflammatory acne. It may help to try: washing the face with lukewarm water and soap twice daily washing the whole body every 2 days reducing stress eating a healthful, balanced diet staying hydrated avoiding over-washing or irritating the skin limiting exposure to the sun always wearing sunscreen when outdoors People should never pop acne blemishes. Doing so can lead to complications, such as: nodules cysts scarring dark spots pitting Inflammatory acne types Inflammatory acne blemishes include: papules pustules nodules cysts Inflammatory acne is more severe than noninflammatory acne, and this type is more likely to cause complications, such as scarring or pitting. Blemishes or lesions that are inflamed, or red, swollen, and warm to the touch can result from inflammatory acne. Minor-to-mild forms Papules Papules are bumps under the skin's surface. They are solid, tender, pink, and raised, and the skin around a papule is usually slightly swollen and red. Unlike whiteheads, papules have no visible center. Unlike blackheads, the pores of a papule do not appear to be widened. Papules develop when whiteheads or blackheads cause so much irritation that they damage some of the surrounding skin. The damage leads to inflammation. Pustules (pimples) Pustules are larger, tender bumps with a defined circular center. The center is filled with whitish or yellowish pus, and the bump has a pink or red base. Immune cells and bacterial cells collect to form this pus. Pustules typically look like much larger and more inflamed whiteheads. Treatment options Several home remedies and over-the-counter medications can treat minor-to-mild papules and pustules. The following tips can help: washing the affected area with cool water and soap using clean hands or a clean, gentle facecloth twice a day applying a warm compress or cloth to the affected area for 10–15 minutes to encourage trapped debris to rise to the surface using products with benzoyl peroxide to combat bacteria using products with salicylic acid to remove dead skin cells and other debris How do you prevent pimples? How do you prevent pimples? How can you prevent pimples from forming? Learn 15 methods of prevention here, including home remedies, lifestyle changes, and diet tips. READ NOW Moderate-to-severe forms Nodules Nodules are hard, painful, inflamed lumps located deep within the skin. They look like larger, deeper papules and have no visible center or head. This type of acne lesion develops when clogged pores damage tissues and cells deep beneath the skin's surface. Nodules are a severe form of acne blemish, and they can cause skin complications such as dark spots or scarring. Cysts Cysts are very large, soft, painful, red or white lumps situated deep in the skin. They are filled with pus. Cysts form deeper within the skin than nodules, and they are the most severe type of acne blemish. Cysts can also cause skin complications, such as scarring. Treatment options People cannot treat moderate-to-severe inflammatory blemishes at home. These lesions require care from a doctor or dermatologist. The doctor can use many products and procedures to treat nodules and cysts. These include: antibiotics, such as tetracycline, doxycycline, and amoxicillin topical corticosteroids oral contraceptives for hormonal-related acne systematic retinoids, such as isotretinoin steroid injections chemical peels photodynamic therapy to combat bacteria drainage and extraction to remove large cysts What causes acne? young woman with forehead acne When a pore becomes clogged, acne can develop. Normally, dead cells collect in the skin's pores, then slowly rise to the surface of the openings and eventually fall away from the skin. A natural body oil called sebum helps to prevent skin cells from drying out. The glands that produce this oil are attached to the pores. When excess sebum builds up, it can cause dead cells to stick together, forming a mixture that becomes trapped in the pores. Acne occurs when a pore becomes clogged with dead skin cells, natural body oils, and a type of bacteria. These bacteria live on the skin and are called Propionibacterium acnes. If they enter and infect clogged pores, this causes acne blemishes to form. When to see a doctor In cases of minor-to-moderate acne, a person will generally have to use home and over-the-counter remedies consistently for 4–8 weeks before they see results. More severe inflammatory types of acne tend to take much longer to clear up. Speak to a doctor or dermatologist if whiteheads, blackheads, papules, or pustules: are severe do not respond to over-the-counter medications are very painful are very large bleed a lot release a lot of pus cover a significant portion of the face or body cause emotional distress develop very close to sensitive areas, such as the eyes or lips Most active ingredients in over-the-counter products are available in prescription-strength treatments. Dermatologists can also remove lesions that are very large or persistent. They can also remove those that do not respond to other forms of treatment. Always see a doctor or dermatologist about nodules and cysts, because these require medical care. Untreated nodules and cysts and those that have been picked or popped can cause scarring.

What Is an Appendectomy? An appendectomy is the surgical removal of the appendix. It’s a common emergency surgery that’s performed to treat appendicitis, an inflammatory condition of the appendix. The appendix is a small, tube-shaped pouch attached to your large intestine. It’s located in the lower right side of your abdomen. The exact purpose of the appendix isn’t known. However, it’s believed that it may help us recover from diarrhea, inflammation, and infections of the small and large intestines. These may sound like important functions, but the body can still function properly without an appendix. When the appendix becomes inflamed and swollen, bacteria can quickly multiply inside the organ and lead to the formation of pus. This buildup of bacteria and pus can cause pain around the belly button that spreads to the lower right section of the abdomen. Walking or coughing can make the pain worse. You may also experience nausea, vomiting, and diarrhea. It’s important to seek treatment right away if you’re having symptoms of appendicitis. When the condition goes untreated, the appendix can burst (perforated appendix) and release bacteria and other harmful substances into the abdominal cavity. This can be life-threatening, and will lead to a longer hospital stay. Appendectomy is the standard treatment for appendicitis. It’s crucial to remove the appendix right away, before the appendix can rupture. Once an appendectomy is performed, most people recover quickly and without complications. Why Is an Appendectomy Performed? An appendectomy is often done to remove the appendix when an infection has made it inflamed and swollen. This condition is known as appendicitis. The infection may occur when the opening of the appendix becomes clogged with bacteria and stool. This causes your appendix to become swollen and inflamed. The easiest and quickest way to treat appendicitis is to remove the appendix. Your appendix could burst if appendicitis isn’t treated immediately and effectively. If the appendix ruptures, the bacteria and fecal particles within the organ can spread into your abdomen. This may lead to a serious infection called peritonitis. You can also develop an abscess if your appendix ruptures. Both are life-threatening situations that require immediate surgery. Symptoms of appendicitis include: stomach pain that starts suddenly near the belly button and spreads to the lower right side of the abdomen abdominal swelling rigid abdominal muscles constipation or diarrhea nausea vomiting loss of appetite low-grade fever Although pain from appendicitis typically occurs in the lower right side of the abdomen, pregnant women may have pain in the upper right side of the abdomen. This is because the appendix is higher during pregnancy. Go to the emergency room immediately if you believe you have appendicitis. An appendectomy needs to be performed right away to prevent complications. What Are the Risks of an Appendectomy? An appendectomy is a fairly simple and common procedure. However, there are some risks associated with the surgery, including: bleeding infection injury to nearby organs blocked bowels It’s important to note that the risks of an appendectomy are much less severe than the risks associated with untreated appendicitis. An appendectomy needs to be done immediately to prevent abscesses and peritonitis from developing. How Do I Prepare for an Appendectomy? You’ll need to avoid eating and drinking for at least eight hours before the appendectomy. It’s also important to tell your doctor about any prescription or over-the-counter medications you’re taking. Your doctor will tell you how they should be used before and after the procedure. You should also tell your doctor if you: are pregnant or believe you may be pregnant are allergic or sensitive to latex or certain medications, such as anesthesia have a history of bleeding disorders You should also arrange for a family member or friend to drive you home after the procedure. An appendectomy is often performed using general anesthesia, which can make you drowsy and unable to drive for several hours after surgery. Once you’re at the hospital, your doctor will ask you about your medical history and perform a physical examination. During the exam, your doctor will gently push against your abdomen to pinpoint the source of your abdominal pain. Your doctor may order blood tests and imaging tests if appendicitis is caught early. However, these tests may not be performed if your doctor believes an emergency appendectomy is necessary. Before the appendectomy, you’ll be hooked up to an IV so you can receive fluids and medication. You’ll likely be put under general anesthesia, which means you’ll be asleep during surgery. In some cases, you’ll be given local anesthesia instead. A local anesthetic numbs the area, so even though you’ll be awake during the surgery, you won’t feel any pain. How Is an Appendectomy Performed? There are two types of appendectomy: open and laparoscopic. The type of surgery your doctor chooses depends on several factors, including the severity of your appendicitis and your medical history. Open Appendectomy During an open appendectomy, a surgeon makes one incision in the lower right side of your abdomen. Your appendix is removed and the wound is closed with stiches. This procedure allows your doctor to clean the abdominal cavity if your appendix has burst. Your doctor may choose an open appendectomy if your appendix has ruptured and the infection has spread to other organs. It’s also the preferred option for people who have had abdominal surgery in the past. Laparoscopic Appendectomy During a laparoscopic appendectomy, a surgeon accesses the appendix through a few small incisions in your abdomen. A small, narrow tube called a cannula will then be inserted. The cannula is used to inflate your abdomen with carbon dioxide gas. This gas allows the surgeon to see your appendix more clearly. Once the abdomen is inflated, an instrument called a laparoscope will be inserted through the incision. The laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The camera will display the images on a screen, allowing the surgeon to see inside your abdomen and guide the instruments. When the appendix is found, it will be tied off with stiches and removed. The small incisions are then cleaned, closed, and dressed. Laparoscopic surgery is usually the best option for older adults and people who are overweight. It has fewer risks than an open appendectomy procedure, and generally has a shorter recovery time. What Happens After an Appendectomy? When the appendectomy is over, you’ll be observed for several hours before you’re released from the hospital. Your vital signs, such your breathing and heart rate, will be monitored closely. Hospital staff will also check for any adverse reactions to the anesthesia or the procedure. The timing of your release will depend on: your overall physical condition the type of appendectomy performed your body’s reaction to the surgery In some cases, you may have to remain in the hospital overnight. You may be able to go home the same day as the surgery if your appendicitis wasn’t severe. A family member or friend will need to drive you home if you received general anesthesia. The effects of general anesthesia usually take several hours to wear off, so it can be unsafe to drive after the procedure. In the days following the appendectomy, you may feel moderate pain in the areas where incisions were made. Any pain or discomfort should improve within a few days. Your doctor may prescribe medication to relieve the pain. They might also prescribe antibiotics to prevent an infection after surgery. You can further reduce your risk for infection by keeping the incisions clean. You should also watch for signs of infection, which include: redness and swelling around the incision fever above 101°F chills vomiting loss of appetite stomach cramps diarrhea or constipation that lasts for more than two days Although there’s a small risk of infection, most people recover from appendicitis and an appendectomy with little difficulty. Full recovery from an appendectomy takes about four to six weeks. During this time, your doctor will probably recommend that you limit physical activity so your body can heal. You’ll need to attend a follow-up appointment with your doctor within two to three weeks after the appendectomy.

Tinnitus (TIN-ih-tus) is the perception of noise or ringing in the ears. A common problem, tinnitus affects about 1 in 5 people. Tinnitus isn't a condition itself — it's a symptom of an underlying condition, such as age-related hearing loss, ear injury or a circulatory system disorder

Corneal cross-linking (CXL) is an in-office eye procedure that strengthens the cornea if it's been weakened by keratoconus, other corneal disease, or (rarely) a complication of LASIK surgery. Alternative and brand names for the procedure include corneal cross-linking, corneal collagen cross-linking, C3-R, CCL and KXL.

With keratoconus, the clear, dome-shaped tissue that covers the eye (cornea) thins and bulges outward into a cone shape. Its cause is unknown. Symptoms first appear during puberty or the late teens and include blurred vision and sensitivity to light and glare. Vision can be corrected with glasses or contact lenses early on. Advanced cases may require a cornea transplant.

An eye web is a noncancerous, triangular growth that may occur on one or both eyes. It's more common in people who spend a lot of time in the sun, such as those who work outdoors. The painless growth may be slightly raised and contain obvious blood vessels. It may cause irritation and possibly affect vision. Treatment usually isn't necessary. Eyedrops or surgery may help in severe cases.

LASIK eye procedure for correcting vision

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