Today I welcomed back Dr. Chong from her Spring Break in Utah. She said it was very enjoyable and snowy. And yet here in Arizona, it's the first day of spring and it already feels like the beginning of summer! I began scoring a few of the COMPASS 31’s from the patient files using the program I helped to create last week. It worked like a charm, and I’m super proud of my work. Then for the rest of the day, I finished up the second case study Dr. Chong had made up for me. This time it was “A 60-yo male who came to the ER with ‘the worst headache of his life.’ He had dizziness, vomiting, and blurred vision. However, no fever was reported. Two weeks previous, he experienced a similar headache, but he had not gone to the ER. His medical history comes up as normal.” So, what happened? Below is a screenshot of the spreadsheet that I created for this case. The colors don’t mean anything, I just wanted to be able to distinguish the different diseases that I had listed, except the purple boxes, which are the definitions of terms I didn’t know or needed a refresher of. For my second case study, I’ve now ranked the diseases from least likely to most likely. My research has shown that this patient might be suffering from one of the following: Dehydration, A concussion, A stroke, A migraine, or A Brain Aneurysm.
Then on Wednesday, I showed Dr. Chong what I had found. She was also thinking this patient was suffering from a brain aneurysm, the "ballooning" of a blood vessel in the brain. After I shared my research, she went into a little more detail about each of my 'diseases', mainly how these are diagnosed as well as the surgery required for the more dangerous conditions (stroke and brain aneurysm). With a stroke, surgeons can provide medications (such as TPA) to dissolve the blood clot, resuming blood flow to the brain, or perform a carotid endarterectomy, removal of the arterial plaque that runs along each side of the neck to the brain. Another possibility is the use of angioplasty and stents, which is the insertion of a balloon into the carotid artery to expand a narrowed artery and supported by a stent. Unfortunately, the medication will only work if the signs of stroke are caught within a certain period of time. If not, surgery will have to be involved to regain blood flow to the brain.
With a brain aneurysm, they can use a cerebral angiogram, the less invasive option, where a catheter is inserted into the groin to navigate to the enlarged blood vessel. Once there, it will eject tiny detachable coils into the area, blocking blood flow and allowing a blood clot to form. However, if the blood vessel has already begun to burst, they'll have to use surgical clipping, the invasive option, in which they will enter through the skull to clamp the base of an aneurysm and stop blood flow to it.
On Thursday, there wasn't much to report. I started out by scoring some straggler patient files from the Structural and Functional Neuroimaging in Patients with Headache Disorders study. Although, Dr. Chong was able to show me, on a small scale, the beginning process of analyzing this collected data.
My expectations going into this part of the study was that there would be a lot of statistics involved (fortunately I can still remember some of the stats terms I learned in AP stats like z scores and t tests). Not sure if that vocab will come in handy, but we'll see. For this analysis, Dr. Chong used a program called the SPSS Statistics Viewer, which is some sort of tool used to statistically analyze sets of data. We compared the ages, pain thresholds, and sensitivities to light and sound between those with cluster headache, migraine, and the healthy controls. We found the mean age to be highest in cluster headache patients, and the pain threshold to be highest in migraine patients. It has also been observed that migraineurs are most sensitive to light than those with cluster headache. Researchers aren't really sure why this is yet, but they're hoping these studies will provide some answers.
That was all for this week! Hope you enjoyed my post, and I thank you all for your continued support and thoughtful comments over the past weeks!!
