After a while we started feeling light and Captain Harkness announced that spin would be off the ship for a short time. Sometimes relates to microbes, which can exist without oxygen. A membrane made with a polyamide-based polymer consisting of three layers: Overview The ventricles of the brain are a communicating network of cavities filled with cerebrospinal fluid CSF and located within the brain parenchyma. May be difficult to remove by chemical means due to multiple layers and lack of fluid dynamics at surfaces where it resides. Our amps are exactly the same and will still be able to run full power with Hot Plates or other attenuators as they have always been.
There is also a certifying examination that is taken after passing the qualifying examination. The surgeon is required to re-certify in surgery in order to re-certify in colon and rectal surgery every 10 years.
Bowel resection surgery is a major operation performed in a hospital setting. The cost of the surgery varies significantly between surgeons, medical facilities, and regions of the country. Patients who are sicker or need more extensive surgery will require more intensive and expensive treatment. Definition Bowel resection is a surgical procedure in which a diseased part of the large intestine is removed.
To remove a portion of the colon, or large intestine, and incision is made in the abdomen to expose the area A. Description Bowel resection can be performed using an open surgical approach colectomy or laparoscopically.
Colectomy Following adequate bowel preparation, the patient is placed under general anesthesia, which ensures that the patient is deep asleep and pain free during surgery. Laparoscopic bowel resection The benefits of laparoscopic bowel resection when compared to open colectomies include reduced postoperative pain, shorter hospitalization periods, and a faster return to normal activities. These three maneuvers are: Aftercare Postoperative care for the patient who has undergone a bowel resection, as with those who have had any major surgery, involves monitoring of blood pressure, pulse, respiration, and temperature.
The treating physician should be informed of any of the following problems after surgery: Risks Potential complications of bowel resection surgery include: Normal results Complete healing is expected without complications after bowel resection, but the period of time required for recovery from the surgery varies depending on the initial condition that required the procedure, the patient's overall health status prior to surgery, and the length of bowel removed.
Morbidity and mortality rates Prognosis for bowel resection depends on the seriousness of the disease.
Alternatives Alternatives to bowel resection depend on the specific medical condition being treated. Am I a candidate for bowel resection? How many patients with my specific condition have you treated? How long will it take to recover from surgery? What do I need to do before surgery? What happens on the day of surgery? What type of anesthesia will be used? What happens during surgery, and how is the surgery performed? Also read article about Bowel Resection from Wikipedia. A not very nice colonoscopy was performed.
It hurts, but now at least I know its not cancer. What are the chances of me not needing one at all Cut - rejoin and low residue diet to ease the newly joined bowel back into use?. Good site though and you have answered some of my fears and questions. I am 58 yrs and fit. Your article was very informative! My doctor is doing a Transverse Bowel Resection surgery on me.
He will be cutting into my stomach instead of the laproscope surgery. Has anyone out there gone through this specific surgery?
Also, I did not think to ask him why not the laproscope, since it is a shorter recovery. I had a boyfriend which I known him almost 4 monthes. He tald me that he had surgery for bowel resection 9 monthes ago. He taled me that he we can't have baby if we are marryed becoth of his surgery. Can this surgery has this kind of risk?
Pleas email me becouse I wan't to give him the ansewr and support him in every way i can. I had an injury 11 years ago that required an emergency bowel resection of the ascending colon.
From what I understand the entire ascending colon was removed, the doctor told me that he removed approx. I had a bowel resection and lived with an ileostomy for 5 months for the resection to heal. I had the stoma reversed 9 weeks ago Thank God and I cannot go through a day without immodium for the diahrrea and gas. Is there any bright light at the end of the tunnel for the diahrrea?
They also removed an ovary at the same time with laproscopy. When will normal bowel function start? I have frequent urges to go to the bathroom with little void. I think I have delveloped hemroids also. This article was very informative. I am a Nurse and my dad was diagnosed with sigmoid colon cancer a few days ago.
He is undergoing surgery for a colectomy this friday. I am nervous, scared and very apprehensive but I believe the surgeon we have chosen is very skilled in what he does. The surgeon said he will take several lymph nodes during the surgery to see if the cancer has spread. If the polyp hasn't invaded the muscle layer of the colon what are the chances that it hasn't spread???
Specific questions re your surgery must be directed to your surgeon.. I strongly recommend it as a post operative preventative maintenance I had a small bowel resection with a TA stapling device in many hospital visits X9 small bowel obstructions, untill a doctor would finally listen went in to do surgery and found no scare tissue causing obstructions..
I had a resection surgery conducted about 1 year ago. My ascending colon and appendix was removed. I was told I would have a complete recovery.
The surgeon explained the rest of the intestinal system will re-learn how to process food, especially liquids. So far, I still run to the bathroom about 1 to 2 times a week. From what I understand, the urge is compared to child birth labor urge. I suspect this stems from not having the A-colon.
On average, I have bowel movements 3 times a day. Somedays it is only 1, somedays it is 6 to 7 times a day. Hard to say why; have not found a pattern yet. Except for bready or doughy food products, my diet has changed little.
Although, I have made it common to not eat as much fast-food or spicy foods. Notwithstanding the extra gas and loud processing of the food and evidence of surgery, I feel pretty normal. But I am fairly certain I will never have constipation or very solid stools. If anyone has more comments insight or just questions and wants an exchange of thoughts, email me at sdflipper yahoo.
Use some website reference so I know it probably wont be spam. I read my email about once a week. I am having a sigmoid resection and colo-vaginal fistula repair. I am very scared. I would think it should not be any worse than I feel right now. Has anyone else had this combination surgery? What am I in for? My surgery is set for August 13th. Any pre-op hints would be greatfully appreciated.
You can email me at firecopper sbcglobal. He has a large polyp which was unable to be removed via colonoscopy. They at Hopkins also found dysplasia He's meeting with the doc this week to discuss what to do next We are praying there is no cancer.
They took 10 markers to check for cancer and when the doc called him he said he wasn't sure as of yet, but is calling in an Oncolongist. Please pray and our prayers are with you all that have to go through this. I have just sent a note to Sheri Main difficulty is still not having normal bowel function Hoping time will help, along with imodium tablet once a day. I am 30 days post op from sigmoid colon resection surgery.
Doing OK overall but last few days feeling an awful lot of pain in lower abdomin by inscision. Is this normal at this time. My scar is about 6 inches long. I have started moving more and started to work from a bit.
I am worried about really pulling on something and develping a hernia in that area. Are there any tell tale signs of a hernia associated with this surgery or around the inscision? Thanks for the help: My Dr has 30 years experiance and did the operation using the large scar and staples. I was happy with that as I am an old operating room nurse. I believe he can get a much better view through the larger opening. I did develop a paralitic ileus which took two weeks to resolve. They gave me Morphine 2 mgs for pain i had nightmares with this and asked them to cut it in half then asked them to cut it out after a week.
I think the narcotic had something to do with the ileus. I am home now and getting stronger with each day , bowel movements will probably never be the same, i use Milk of magnesia which works well.
I expect to be back to normal in another month. I have had four colonoscopies in 6yrs and the latest showed up 35 polyps none were cancer. My surgeon has told me that because of the number of polyps he would do another colonoscopy in 6months which is two months from now. He has indicated if polyps are found he will do a gene test to see if the suspecting gene is activating the large number of polyps. He has also indicated that eventually if polyps continue at this rate that it is inevitable that one would be cancerous and an operation to remove part or all of the bowel should be undertaken.
Can anyone tell me if this is how things are done considering my history or are they just letting me know the worst case scenario. I have read the article and does the information still comply, the reason why I am asking is, My Mother has recently had a resection, unfortunately didn't go according to plan, I am not sure whether her bowel was cleaned prior to surgery and she was on normal diet literally 12hrs after surgery hence she had to have emergency surgery where by she ended up with an ileostomy and in Intensive Care, also had to have a further 2 more ops including traceostomy, still there, I am a nurse and it is hard for me to understand how this happened.
Hi, Could you send me a sample diet for a recovering patient, I'll be caring for my sister who had emergency surgery in Mexico and will return next week. What should they add or delete from their previous diet. What is a normal activity level.. It has been 4 years since my Bowel Resection. I recently yesterday had a Bowel movement which contained Blue Suture material tangles with fiber. When I pulled on the suture material to get it the rest of the way out it hurt so I cut it off up as far as I could.
Can you tell me what is going on with my body. How did this material get loose about 10 inches came out and still some in there. Is there any danger of infection.
I called the surgon's office but can't get into see him for a couple weeks. Staff did not think this was serious. I am really afraid. Thanks for your help.
My husband and I live in a motorhome fulltime, so we are fairly mobile! My new diagnosis is intestinal pseudo obstruction, and I have elongated and tortuous intestines per colonoscopies. Elective resection surgery was posed to me as a possibility, and I'm intrigued by the laparoscopic approach.
What source should I use to locate an experienced surgeon? We are currently in Lake Placid, Fla. Family, Please read this so you will know what I will be up against the end of January. This should answer all your questions. As a Nurse and a patient I am scheduled for a sigmoid colectomy due to perforated Diverticulitis with abscess formation in the near future ,I found your article to be informative and well written. It is my hope that any patient who requires major surgery will empower themselves with knowledge regarding their surgical procedure.
I am getting sicker as the days go on. Lots of presure and pain in my belly,back and bladder. Still have constipation so take a prescription laxative. Yesterday went to the bathroom 15 times. If I don't take the laxative I will be in pain and unable to go.
Can't eat or I will get deathly sick. Going into a deep depression. I am not the person I use to be. It has been over a year that I have been this sick. Thinking about telling them to take the rest of my Sigmoid and live with a bag! I am 53 and trying to get my New Senior Home Care business off the ground.
Thought you might be interested in this. I'm sure you guys will be checking all of this out too. My son needs a bowel resection due to a perforation in his bowel and it's going into his bladder. He has a mesh in his abdomen because he had his spleen out 9 years ago from a car accident.
Will this mean that he cannont have the laproscopic surgery? My mom had bowel reef survey six months ago and has had nothing but issues with it the thing is constent tummy pain through out her tummy and know one can tell is what is wrong could the survey been done wrong.
My husband was operated on a week ago for a bowel reconnection. So far he has not passed any wind and his abdomen is very swollen and dilated and painful. What is the next treatment required? I had a sigmoid colon resection surgery on Feb. I had a great surgeon!!!
I went home 7 days later. Sore and 37 stainless staples to be removed on the 23rd of this month. I suffered with diverticula disease for years and the pain got so intense I passed out driving. I decided I had no more choice. I am thankful all turned out well. I had a regular anesthetic as well as an epidural in my back.. When you wake up you don't have to experience the pain.
Nothing by both except ice chips. Then after you get the bowel sounds back and pass gas they give you clear liquid. Then the next day or so. I am home and tolerting a regular diet. I haven't got a big appetite but need to focus on the healthy side and eat healthy when I can. If anyone needs a fantastic surgeon, I live in AZ.
He is a general and vascular surgeon. Fantastic bedside manner also Hope this info helps someone. Went into the ER nearly a month ago for diverticulitis pain - ended up one of the diverticuli was perforated, leaking infection into my stomach. IV antibiotics cleared up the infection and I was sent home with more antibiotics and pain pills, which, thank goodness, I didn't take much of.
Now I am having pain again - while in the hospital a general surgeon told me I needed a resection and would be receiving a colostomy. I've read that a "bag" is not always necessary. I'm clearly going to have to undergo the surgery in the very near future, but can't stand the thought of a colostomy and a second surgery to remove it.
TANA dont worry about a "bag" i went in for resection on 27th April and came out 25th May with out bag but had problems while in hospital and since coming out only wish my doctor would have given me a bag people with bag fitted were going home after days i still off work and have been told to expect another 2 months off thats 4 month in all.
Thank you for all this insight, I have just resently been diognosed with Colon Inertia, and they are scheduling surgery the first or second week in Sept. Just wondering is someone can explain what that is, and what kind of sugery it involves. And can it possible be cancerous? Thank you for any help, Tami. I had a lower bowel resection in August because of a carcinoid tumor.
Since then I have gotten sharp left side pain. It hurts to lay on my right side when I have these pains, but somewhat tolerable on the left. Is there a serious reason for this or is it a result of the healing? Thank you in advance for your help, Linda. I had a lower bowel resection in august of this year I am having lots of bowel issues. I have frequent urges to go but with little relief. Some days okay but most not. I have developed hemroids also with some bleeding.
Does this ever get better? Jean, An epidural would not be appropriate for a procedure to that extent however I would ask about a spinal block, similar to an epidural but the medications are administered into two different locations. Epidural is only administered into the dura mater of the spine and the spinal block is administered in the subarachnoid space; allowing the medication to get into the CSF.
Epidural is nice for a woman in labor but thats about it, a spinal provides loss of sensation to the entire body below the diaphragm. I really hope this helps but I am not an anesthesiologist or a doctor just a surgical technologist in training.
I had my sigmoid removed due to severe diverticulitis and now I keep going to the bathroom. How long does it usually take to get back to normal? Dr did Follow-up CT Scan.. Everything Good He says Patience? I am going in feb 6th for my second resection. My first was in I did not listen to doctors advice and quit taking my medication for Crohns disease after first surgery because i felt great. Now i wish that i would have. I was in the hospital for 31 days with the first one, complications.
This one is scaring me because all i have to go by is what happened the first time. My doc is a great doc and told me that he has never lost a patient from this surgery and i am not going to be his first. Hope all goes well.
I was in a car accident when i was 9 years old and suffered from seatbelt injuries which resolted in a bowel resection where they removed over 12 inches of my large intestine. I was becoming to be back to normal around a month after my wreck and have been in fine health since. I had twin daughters and had a c sec something i thought my prior surgery would interfere with but all went well and am pregnant with number 3 and planning oon another c section.
My Grandmother is in terrible pain from a gas build up in her stomach, she is not able to relieve the pressure through her stoma. She has lived with the bag for most of her life and has not had this problem before. The bouts come almost every day, sometimes twice a day and last for some hours, it is excruciating for her and very distressing for the family.
The doctors have ruled out a hernia or any form of blockage, and advise nothing more than strong painkillers. I read above that sipping peppermint essesence in hot water and eating natural yoghurt can help, has anybody tried these remedies?
I had a bowel resection from diverticulies in November of I also have a transplanted Liver and Kidney in I too have had bowel movement problems since , some before but much worst since. My problem is I have diarreah also every day, and it starts around midnight and goes all night until about 6 or 7 in the morning. I am talking 3 fiber pills every day 1 in the morning and 2 in the evening.
Doesn't help much, can anyone tell me why this only happens int night and not in the day. They thought it was what I was eating but it doesn't seem that it only one kind of food. Any advice will be greatly appreciated. I have a simnoid colon resection in August of 9 CM removed. Since then I have been in and out of the hospital because of severe bloating and pain, however every test run shows absolutely no problems. Most days I have bowel movements in excess of 5 with no true pattern.
One may be diarhea, the other solid, one soft, etc. I feel like it is wasting the time of many going to the hospital so much, but am clueless to what is going on, Any suggestions.
My diet is watched closely, etc. I had to have a temp. It has healed nicely, however I have these 2 pones on either side of my incision middle. Is this fat or could it be scar tissue. Two years ago I was dianosed with a large tumor. They removed about 12 inches of my colon as well as my cicum. I take one diarrhea daily. Sometimes it works and sometimes it does not.
Is there any other medications I can take that is better for my system? What are some foods that would be good for me? To Mike, Jimmy and Pat. I also had a colon resection done cancerous polyp in September of Everything that you have described is probably what most people experience.
My first year was extremely frustrating, but it does get better. I have tried many ntural remedies and my chiropractor advised me to be sure and take probiotics the refrigerated ones found at nutrional stores and an enzyme for digestion. Ijust bought some fennel tea which aids in digestion and gas, etc and will let you know how that works.
What I have found out with my diet, is the best thing to do is not eat too much of a variety of foods at one time. I love vegtables, fruits, etc but they dont always digest well.
Also, eat small amounts of the foods you like and that helps me alot. Walking and excersize helps. It is extremely frustrating at times, but don;t give up too soon. My next step is to go see a dietician for further help. If any of you wish to e-mail me, my e-mail address is lindaflanigan live. We have to be there for moral support, beleive me!!! PS I go see Dr every 6 mos now for my blood work.
Good luck to all of you, and if you have any of your own suggestions, please pass them along. I had right hemi colectomy six months ago and yes I had trouble with diarhhea. It eventually turned out I had become extremely lactose intollerant and still cant each raw vegetables like salad. So it may be you need to adjust your diet. Keep a diary, remove some foods and see what happens. I had a Right hemi colectomy 6 weeks ago because i had a very large pre-cancerous polyp, i was 27 years old at the time which is extremely rare, and am lucky to be alive.
I was distended and in horrible pain for 10 days, in hospital for My bowels began to work again on their own, peppermint tea helped allot and moving around in bed, feels like it will never end but does. I also had an Ileus, which resulted in me having a gastric tube placed down my nose into my stomach to drain the bile from my stomach, it was the worst ten days of my life bar none, i couldn't eat until day These symptoms a rare but thought people should know what can occur.
I have a massive scar which has only just healed, still have muscle pain around the abdomen. I had a bowel resection in Aug due to diverticulitus and then had to have a tidy up in January due to scar tissue and the reconnection not being the best.
Before I had the resection, I had lost a load of weight and was in fact under weight, but since my last operation I have gained fat around the laporoscopy area which is very uncomfortable. I eat sensibly and actively exercise, but nothing will shift this great lump from my stomach.
Like others, I suffer with loose stools, persistent wind and quite frequent diarehoea. My stomach problem is affecting not only my ability to buy clothes, but is VERY uncomfortable when doing yoga and pilates. I am a 46 year old woman who on August 6th had a complete hysterectomy and bowel resection. I had a mass of endometriosis on my rectum, so that is why I had to have the resection. I had an ileostomy for almost 3 months, so the resection could heal I had the ileostomy take down 3 weeks ago.
Still am afraid to leave the house for more than 20 minutes. If I make a quick run, I make sure I put on an adult brief. I can hardly make it to the bathroom. How long before this gets better? Is there anyone else out there who had this kind of trouble for endometriosis.
Please let me know. Hello, The article is very good. Just I want to point to some rare indications for partial or total colectomy that were not mentioned in the article but I have met in many references , they are pseudomembranous colitis that can not be controlled by chemotherpeutics , chronic dys-functional colitis , and ischaemic bowel diseases which is common only in very old patients.
Thank you for this article. I have recently undergone my 4th operation for chrons related symptoms, 2 resections approx 8 strictures, my recent surgery went well but i am now concerned because my surgeon has called me up and wants to speak to me ASAP regarding results they have from the damaged bowl.
I am dreading the consultation as I fear the worst ie cancer. My point, I have not found any articles that prepare you for this situation post op, ie what happens after the operation what gets tested and why? Anyways I had a look at the percentages regarding colorectal cancer and this is encouraging so thank you for providing this information. I know this may not be the results that are given but I fear the worst, I suppose it's in some of our worst fears that get confirmed that gives me great concern.
I have been dealing with IBSC for over a decade now; I was put on Amitiza and worked my way up to the maximum dose allowed with no relief. I have had a colonoscopy and am on my 2nd Sitz-Marker test.
I am now taking a cocktail of OTC constipation remedies that help a little but, Heaven forbid, should I skip even one of them; this cocktail consists of 75 - mg of sennosides, 1T Citrucel and 17g of Miralax..
I am currenty consulting with a surgeon as I am considering colectomy. I have found very little reference as to the long term results of a colectomy for constipation. I am actually considering just a partial colectomy as my colon is not damaged or diseased My surgeon warned me of loose stools and bowel incontinence after the surgery; but, he is also only thinking of a total colectomy.
Any information, suggestions or experiences would be greatly appreciated. In I was rushed to Emergency 3 times due to abdominal pain. It was discovered after much prompting on my part to my doctors that I had Cecum Bascule. I had 2 feet of my large colon removed along with my cecum. This disorder creates multiple polyps and research indicates they do not discover this disorder until autopsy from death by Colon Cancer. Since that time I was diagnosed with Diabetes.
I have chronic diarrhea and any change of diet has no affect. As time passes, the diarrhea gets worse and at this point feel like I have Crohns because I can't be far from the bathroom as when I have to go, I have to go now. In addition, I cannot find much information because this is so rare. When you are going to have a resection, make sure you get the facts about not just the after care but the long term care.
My husband has a fistula related to melanoma cancer connecting his intestine to his colon. He will be having a double bowel resection to remove the fistula. Does it get better? He currently has diarrhea times a day with no relief from immodium.
I had abowel resection Feb. My life has not been the same since. I really would like to have someone to talk too. I can not be away from a bathroom and most days I do not feel well at all.
I have no control of my bowel movements,i still where adult diapers. My email is kittyzabroski yahoo. Ihad the resection because of scar tissue. And the gas never in my life I had a partial resection of my colon in following severe bleeding after a colonoscopy. I was on warfarin because of a prosthetic aortic valve. Initially, I was under the impression that very little was left of my colon 4 or 5 inches.
The surgeon could not identify which polyp removal site was causing the bleed so he had to remove most of it. During subsequent colonoscopies my colon appears to be getting longer.
Either the orignal estimate was wrong or my colon is growing. I am age I also have Marfans syndrome. In I was diagnosed with acromagely. I have had surgery for both conditions. I had the tumor on my pituitary removed, but my growth hormones IGF1 continue to be outside the normal range.
Could the excess growth hormones cause my colon to grow, or should I consider that initial estimate in to have been an error? Jack 65 I think the original estimate was off. The colon is 5 feet.
The polyps can be removed without removing any of the colon. I've been through 4 surgeries just found out looking at a 3 resection and 6 polyp removals. My 85 year old mother was diagnosed with diverticulitis in the sigmoid section of her colon in August. She had a 10cm abscess which was drained and 2 drains were inserted, one in the abdomen, the other in her bottom. She is still complaining of nausea but no pain. The doctors want to do the resection but at her age, I'm afraid she shouldn't have this surgery.
She is in a skilled care facility and I feel as long as they can control her other complaints, why put her through such an extensive surgery?
Her quality of life is better now that she is going through rehab and other therapies for other reasons but this is too much for a woman her age. Ultimately, it is her decision but I am trying to give her information on exactly what she will face during and especially after.
They have already said she will have a colostomy, this means yet another surgery to have it reversed. She's not in the best of health as it is and was resigned to enter the facility voluntarily after she could no longer care for herself at her home safely after numerous falls and calls to for help to get up either off the floor or out of the recliner she spent the night in because she couldn't get up.
At her age, I really don't think this type of surgery will prolong her quality of life and may hasten her demise if infection or complications set in. I had sigmoid colon resection 4 months ago. I was able to avoid a bag. I had drainage for 2 mos. When the drainage stopped I felt good having normal bowel movements for maybe the first time in my life. I had chronic diverticulitus for years and it finally perforated my colon.
This past week I started to have pain in area of colon and skin around incision. I went to ER running a temp. My surgeon lanced the area of incision that was last to close and drained a lot of reddish fluid. I left the hospital yesterday after a 48 hr. I am home again with dressings to change along with packing and the oral antibiotics. My question are these; 1 How concerned should I be about reoccurring infection at this point?
I've had several and removed polyps before but don't remember ever hearing they were precancerous. Should I get a colonoscopy sooner? Hy recent surgeon says "I don't need to worry about diet anymore but try not to over do carbs. What are your thoughts about those two things? I want to be as proactive as possible and certainly want to avoid any reoccurring infection and or diverticulitus even though the 8" section removed was the area with the problematic area with the bend removed.
Let me know what you think, thank you. I had chronic diverticulitis. I initially had bleeding for three days after surgery and ended up having to have a blood transfusion.
Could not eat for a few days without throwing up plus had no appetite anyway so was put on IV nutrition. The doc said mine was a complex case. The diseased section was low in the sigmoid colon - 10 inches was cut out.
I was in the hospital for 7 days. I am in third week of recovery at home and doing great for the most part. I try not to just sit or lay down most of day. I get up and move around often and try to do very light housework. Following recovery directions to the T about food and everything else. Still have the occasional aches in stomach area, more good days than so-so days. Balancing rest and exercise is also important. Occupational therapy may include splints, casts, or braces on the affected arm or leg to enable proper limb positioning, prevent joint stiffness, and maintain flexibility and range of motion.
An occupational therapist can recommend assistive equipment and devices to help the child with activities of daily living, such as bathing, dressing, and eating. If a walker or wheelchair are needed, an occupational therapist can provide specific instructions. Physical and occupational therapists can provide guidelines on how to adapt the child's home and school environments to ensure safety and comfort. Speech therapy will focus on the child's specific needs which may include any or all aspects of language use, such as speaking, reading, writing, and understanding the spoken word.
Speech and language problems aphasia usually occur when a stroke affects the right side of the body. Behavioral problems and learning disabilities, such as difficulties with attention or concentration, may become apparent when the child goes to school, so specific treatments and educational assistance may be needed to address these problems. A formal assessment can help parents identify potential behavioral and learning problems.
The need for surgical treatment for pediatric stroke will depend on a number of factors, including the type of stroke, extent of damage from stroke, the child's age, and potential benefits and risks.
Sometimes urgent surgery is necessary soon after the child is admitted to the emergency room to remove a blood clot and restore oxygen flow to the brain tissue. Treatment options for hemorrhagic stroke may include surgery, sterotactic radiotherapy, or interventional neuroradiology to treat the underlying aneurysm or arteriovenous malformation. There are several surgical procedures to repair an aneurysm that may have caused a hemorrhagic stroke. A clip may be placed across the neck of the aneurysm like a clip at the end of a balloon to stop the bleeding.
A newer approach is to thread a long, thin tube through the artery that leads to the aneurysm. Then a tiny coil is fed through the tube into the aneurysm "balloon" to fill the space and seal off the bleeding. An interventional procedure called carotid angioplasty may be performed to treat a blockage or blockages in the carotid arteries. During the procedure, a tiny balloon at the end of a long, thin tube called a catheter is pushed through the artery to the blockage.
When the balloon is inflated, it opens the artery. In addition, a mesh tube called a stent may be placed inside the artery to help hold it open. Carotid endarterectomy is a surgical procedure performed to remove a blockage from the carotid artery. During the operation, the surgeon scrapes away plaque from the wall of the artery so blood can flow freely through the artery to the brain. Intracranial bypass surgery is a surgical procedure performed to restore blood flow around a blocked blood vessel in the brain.
During the surgery, a healthy blood vessel, on the outside of the scalp, is re-routed to the part of the brain that is not getting enough blood flow. This new blood vessel bypasses the blocked vessel and provides an additional blood supply to areas of the brain that were deprived of blood.
When blood flow is restored, the brain works normally, and the symptoms disappear. This procedure is not as common as the other surgical treatments listed above to treat pediatric stroke but it may be used to treat recurrent TIAs.
Alternative and complementary therapies include approaches that are considered to be outside the mainstream of traditional health care. Techniques that induce relaxation and reduce stress, such as yoga , Tai Chi, meditation, guided imagery, and relaxation training, may be helpful in controlling blood pressure. Acupuncture and biofeedback training also may help induce relaxation. Although some practices are beneficial, others may be harmful to certain patients.
Alternative treatments should not be used as a substitute for medical therapies prescribed by a doctor. Parents should discuss these techniques and treatments with the child's doctor to determine the remedies that may be beneficial for the child. Dietary guidelines are individualized, based on the child's age, diagnosis, overall health, and level of functioning. Specific nutritional problems, such as swallowing or feeding difficulties, may be a concern in some patients and should be managed by a team of specialists including a speech therapist.
Early identification, treatment, and correction of specific feeding problems will improve the health and nutritional status of the child. A child's self-feeding skills can impact his or her health outcome. One study indicated that 90 percent of children with good to fair motor and feeding skills reached adulthood.
In contrast, a lack of self-feeding skills was associated with a six-fold increase in mortality rate of death. Maintaining a healthy weight is important to prevent the development of chronic diseases such as diabetes, high blood pressure hypertension , and heart disease. Tube feedings may be required in some patients with failure to thrive , aspiration pneumonia , difficulty swallowing, or an inability to ingest adequate calories orally to maintain nutritional status or promote growth.
A well-balanced and carefully planned diet will help maintain general good health for children who have suffered a stroke. In general, children should follow the same low-fat, high fiber diet that is recommended for the general population. In children older than age two, the following low-fat dietary guidelines are recommended:. If the child has high blood pressure, the DASH diet is recommended. The "Dietary Approaches to Stop Hypertension DASH " study, sponsored by the National Institutes of Health NIH , showed that elevated blood pressures were reduced by an eating plan that emphasized fruits, vegetables, and low-fat dairy foods and was low in saturated fat, total fat, and cholesterol.
The DASH diet includes whole grains, poultry, fish, and nuts. Fats, red meats, sodium, sweets, and sugar-sweetened beverages are limited.
Sodium should also be reduced to no more than 1, milligrams per day. Cerebrovascular disorders are among the top 10 causes of death in children, with rates highest in the first year of life. From to in the United States, childhood mortality from stroke declined sharply, by 58 percent, with reductions in all major subtypes: Some children survive a pediatric stroke with no life-long consequences. In other children, long-term complications of stroke may develop right away or within months to years after a stroke.
According to a study published in the Journal of Child Neurology , the outcome of childhood stroke was a moderate or severe deficit in 42 percent of cases. Adverse outcomes after childhood stroke—including death in 10 percent, recurrence in 20 percent, and neurological deficits in two-thirds of survivors—can be reduced with available stroke treatments. When a stroke affects a child whose brain is still developing, it is thought that the developing brain may be able to compensate for the functions that were lost as a result of a stroke.
Recovery from stroke is different with each child. Overall, the degree of permanent disability after a stroke is less in children than in adults. Speech and language problems usually improve rapidly in the first year after a stroke. Children may only have minor delays in the development of coordinated movement or in cognitive functioning.
Almost all children recover the ability to walk independently after a stroke, unless there is another condition that causes disability. Recovery of function in the affected arm and hand is usually the most significant movement problem after a stroke. Most children who suffer from a stroke can expect to lead independent lives as adults. Despite current treatment, one out of 10 children with ischemic stroke will have a recurrence within five years. Although there is a high risk of repeat strokes in patients with sickle cell anemia, the risk can be reduced with regular blood transfusions.
If no cause of the stroke was identified, the risk of a recurrence is low. If a cause was identified, the underlying condition should be treated, and anticoagulant or low-dose aspirin therapy may be initiated, depending on the child's diagnosis. There is no screening for stroke, but screening exists for many of its risk factors.
To prevent stroke, risk factors should be treated and managed by the child's primary care doctor or specialist. The doctor can advise if specific preventive treatment is needed. Management of high cholesterol—especially high LDL low-density lipoprotein levels—high blood pressure and diabetes can help reduce the risk of a stroke. An adequate intake of folic acid vitamin B9 has been linked to the prevention of stroke and heart disease by lowering homocysteine, an amino acid related to the early development of cardiovascular disease when high levels are present in the blood.
Dietary sources of folic acid include: It is best to eat fresh fruits and vegetables whenever possible to get the most vitamins.
Recommended daily intake in micrograms mcg for folic acid supplements oral tablets include: Vitamin K is an important nutrient needed to regulate normal blood clotting. A diet deficient in vitamin K can cause prolonged blood-clotting time and easy bleeding and bruising.
Vitamin K is found in: Recommended daily intake for vitamin K supplements for patients not on anticoagulant therapy include: If the patient is taking anticoagulant medications, vitamin K supplements are not recommended, and foods high in vitamin K are limited, since they counteract the action of the medication.
Vitamin E and beta carotene supplements were once thought to help decrease the risk of stroke and prevent the development of heart disease, but newer studies disprove their effectiveness. Researchers at The Cleveland Clinic Heart Center performed a meta-analysis of seven large randomized trials of vitamin E given alone or in combination with other antioxidants and eight of beta carotene. All trials included 1, or more patients and follow-up ranged from 1. The doses of vitamin E given in these trials ranged from 50— international units IU and 15—50 milligrams mg for beta carotene.
The meta-analysis reviewed the effect of these antioxidants on death from cardiovascular disease or from any other cause "all-cause mortality". Their findings, published in the June, issue of The Lancet journal, do not support the continued use of vitamin E supplementation nor the inclusion of vitamin E in further studies. Regardless of the dosage given or the patient population, Vitamin E did not provide any benefit in lowering mortality compared to control treatments, and it did not significantly decrease the risk of cardiovascular death or stroke cerebrovascular accident.
In addition, they recommend that vitamin supplements containing beta carotene be "actively discouraged" because of the small but statistically significant increased risk of death. Researchers discourage further study of beta carotene because of the mortality risk. Even though studies have demonstrated that vitamin E and beta carotene supplements do not reduce stroke risk, foods rich in antioxidants are still encouraged because they also contain beneficial nutrients such as flavonoids and lycopenes that are not usually included in standard oral vitamin supplements.
A diet rich in antioxidant-containing foods, such as fruits, vegetables and whole grains, is linked to a reduced risk of cardiovascular disease. Dietary supplements should not be used as a substitute for medical therapies prescribed by a doctor.
Parents should discuss these nutrition supplements with the child's doctor to determine the remedies that may be beneficial for the child.
It is common for a child to feel sad or depressed after a stroke. These emotions may be the result of not knowing what to expect or not being able to do simple tasks without becoming overly tired. Temporary feelings of sadness are normal, and should gradually go away within a few weeks, as the child starts a rehabilitation program and returns to some of his or her normal routines and activities.
When a depressed mood is severe and accompanied by other symptoms that persist every day for two or more weeks, the parent should ask for a referral to a mental health professional who can help the child cope and recover.
There are many treatments for depression. A healthy lifestyle including regular exercise, proper sleep , a well-balanced diet, as well as relaxation and stress management techniques can help manage depression. Major depressive disorder may be treated with antidepressants , psychotherapy supportive counseling or "talk therapy" , or a combination of both. Regular follow-up visits with the child's health care provider will help identify and manage risk factors and other medical conditions.
If the child has a known medical condition that increases the risk of stroke, it is important for parents and caregivers to learn the warning signs and symptoms of stroke in children and infants.
If the child experiences any unexpected neurological problem, the parent should have the child evaluated by a physician. Lastly, it is important for parents to carefully follow the child's treatment plan, including following the medication schedule exactly as prescribed.
The Stroke Recovery Book: A Guide for Patients and Families. A hemorrhagic stroke left compared to a thrombotic stroke right. Rossi, and Karla Dougherty. A Guide For Families: Zimmer, Judith and John P. Broadway Books, August, Recognition, Treatment, and Future Directions. Activities of daily living ADL —The activities performed during the course of a normal day, for example, eating, bathing, dressing, toileting, etc. Aneurysm —A weakened area in the wall of a blood vessel which causes an outpouching or bulge.
Aneurysms may be fatal if these weak areas burst, resulting in uncontrollable bleeding. Antibody —A special protein made by the body's immune system as a defense against foreign material bacteria, viruses, etc. It is uniquely designed to attack and neutralize the specific antigen that triggered the immune response.
Antiphospholipid antibody syndrome —An immune disorder that occurs when the body recognizes phospholipids part of a cell's membrane as foreign and produces abnormal antibodies against them. This syndrome is associated with abnormal blood clotting, low blood platelet counts, and migraine headaches.
Aorta —The main artery located above the heart that pumps oxygenated blood out into the body. The aorta is the largest artery in the body. Aortic valve —The valve between the heart's left ventricle and ascending aorta that prevents regurgitation of blood back into the left ventricle.
Aortic valve stenosis —Narrowing of the aortic valve. Aphasia —The loss of the ability to speak, or to understand written or spoken language. A person who cannot speak or understand language is said to be aphasic. Arteriosclerosis —A chronic condition characterized by thickening, loss of leasticity, and hardening of the arteries and the build-up of plaque on the arterial walls. Arteriosclerosis can slow or impair blood circulation. It includes atherosclerosis, but the two terms are often used synonymously.
Artery —A blood vessel that carries blood away from the heart to the cells, tissues, and organs of the body. Atrial —Referring to the upper chambers of the heart.
Atrial fibrillation —A type of heart arrhythmia in which the upper chamber of the heart quivers instead of pumping in an organized way. In this condition, the upper chambers atria of the heart do not completely empty when the heart beats, which can allow blood clots to form.
Atrial septal defect —An opening between the right and left atria upper chambers of the heart. Cardiologist —A physician who specializes in diagnosing and treating heart diseases. Central nervous system —Part of the nervous system consisting of the brain, cranial nerves, and spinal cord. The brain is the center of higher processes, such as thought and emotion and is responsible for the coordination and control of bodily activities and the interpretation of information from the senses.
The cranial nerves and spinal cord link the brain to the peripheral nervous system, that is the nerves present in the rest of body. Cerebrospinal fluid —The clear, normally colorless fluid that fills the brain cavities ventricles , the subarachnoid space around the brain, and the spinal cord and acts as a shock absorber.
Decompression —A decrease in pressure from the surrounding water that occurs with decreasing diving depth. Echocardiogram —A record of the internal structures of the heart obtained from beams of ultrasonic waves directed through the wall of the chest.
It is often used in the diagnosis of cases of abnormal cardiac rhythm and myocardial damage. An embolus is something that blocks the blood flow in a blood vessel. It may be a gas bubble, a blood clot, a fat globule, a mass of bacteria, or other foreign body that forms somewhere else and travels through the circulatory system until it gets stuck.
Encephalitis —Inflammation of the brain, usually caused by a virus. The inflammation may interfere with normal brain function and may cause seizures, sleepiness, confusion, personality changes, weakness in one or more parts of the body, and even coma. Heart attack —Damage that occurs to the heart when one of the coronary arteries becomes narrowed or blocked. Hemiparesis —Weakness on one side of the body.
Hemiplegia —Paralysis of one side of the body. Hydrocephalus —An abnormal accumulation of cerebrospinal fluid within the brain. This accumulation can be harmful by pressing on brain structures, and damaging them. Hypercoagulable states —Also called thromboembolic state or thrombophilia. A condition characterized by excess blood clotting. Hypertension —Abnormally high arterial blood pressure, which if left untreated can lead to heart disease and stroke. Intracerebral hemorrhage —A cause of some strokes in which vessels within the brain begin bleeding.
Ischemia —A decrease in the blood supply to an area of the body caused by obstruction or constriction of blood vessels. Mitral valve stenosis —Narrowing of the mitral valve.
Neurologist —A doctor who specializes in disorders of the nervous system, including the brain, spinal cord, and nerves. Neurosurgeon —Physician who performs surgery on the nervous system.
Occupational therapist —A healthcare provider who specializes in adapting the physical environment to meet a patient's needs. An occupational therapist also assists patients and caregivers with activities of daily living and provide instructions on wheelchair use or other adaptive equipment.
Patent ductus arteriosus —A congenital defect in which the temporary blood vessel connecting the left pulmonary artery to the aorta in the fetus doesn't close after birth. Patent foramen ovale PFO —A congenital heart defect characterized by an open flap that remains between the two upper chambers of the heart the left and right atria. This opening can allow a blood clot from one part of the body to travel through the flap and up to the brain, causing a stroke. Physiatrist —A physician who specializes in physical medicine and rehabilitation.
Physical therapist —A healthcare provider who teaches patients how to perform therapeutic exercises to maintain maximum mobility and range of motion. Reye's syndrome —A serious, life-threatening illness in children, usually developing after a bout of flu or chickenpox, and often associated with the use of aspirin.
Symptoms include uncontrollable vomiting, often with lethargy, memory loss, disorientation, or delirium.