Saturday, January 9, 2010

Acoustica In My Brain With Sound In My Ear


A patient was referred to my neurology clinic by a very junior emergency doctor who had made an impression of TIA (transient ischaemic attack) involving veterobasillar insufficiency. On further questioning, he had complained of unsteady gait, seeing "double" when looking to the left and slight reduction in hearing abilities. He had lateral rectus palsy (6th cranial nerve) and he manifested left cerebellar signs. Even without an MRI scan , i already can predict this is a problem with lesion in cerebello-pontine.
I was called by a radiologist 3 days later to inform my already expected findings of this benign tumour called ACOUSTIC NEUROMA.,.. or the other name for it...VESTIBULAR SCHWANNOMA. .. A semi-urgent referrral to Penang GH for neurosurgical intervention was made then.
This tumour is associated with Neurofibromatosis Type II.
To junior doctors, be precise in history taking and physical examination to get a proper diagnosis , after all our job acquired us to do so...

4 comments:

Wahidah said...

siap ade pesanan utk jr doc yea..hehehe..yelah dh jd super2 senior doc..:P

syukur said...

senior sikit shj Wahidah ..ha ha
bagi nasihat je...sebab sekarang ni dah ramai doktor2 baru jadi standard mereka tak mcm zaman2 kami dulu...he he

Wahidah said...

i agree with that..kdg2 diorang lepas pandang..even dh jd MO pun kdg2 cechk pt touch n go jer..n kalo end up ngan sumthing worse kn pity kt pt gk..ops terlebih sudah...:P

DrSinga said...

luckily he referred the patient to you...
to some..they might just refer him to the OPD ..delaying the diagnosis ..
salam..
:)