Medical diagnosis of the patient and its types. How to Diagnose by Symptoms or Language

Pain is perhaps the only symptom that every person has felt at least once in their life. And we are not talking about ordinary bruises, but about the pain that is caused by the various pathologies. And it rightfully ranks first in cleanest place headache, which can turn a person’s life into a nightmare. And if she is just a sign of another, hidden and from this even more dangerous disease, then its appearance cannot be ignored under any circumstances.

Causes of secondary headaches

Unlike headaches, which is a disease in itself and most often occurs in people who are in long-term illness, secondary headaches appear against the background of other diseases. In the first case, headache itself has to be treated, while in the second, doctors fight the underlying disease, paying only part of their attention to headaches. When the pathology goes away, the headache goes away too.

Here are the cases in which a symptom such as a headache occurs:

1. Head and neck injuries.
2. Vascular lesions of the spine (cervical spine) and skull.
3. Lesions of intracranial structures not associated with blood vessels:
   • brain tumors;
   • intracranial hypertension of various origins;
   • non-infectious;
   • epileptic seizure.
4. Toxic effects of various chemical substances or cancellation of such influence.
5. Infections, including intracranial.
6. Diseases in which the hormonal, acid-base, and gas balance in the body is disrupted.
7. Pathologies of various structures of the skull, including the facial one.
8. Mental illnesses.

Head injuries

One of the main signs of a concussion is headache. It is usually associated with the moment of trauma or occurs immediately after the person returns to consciousness. However, often, especially with a moderate or severe concussion, a person may not have a headache at all.

Therefore, a doctor observing a patient with a head injury must identify other signs of a concussion:

• behavior change;
• impaired concentration;
• decreased ability to assimilate new information;
• memory impairment;
• impaired coordination of movements, etc.

Of course, the lion's share of these signs can only be identified with the help of people close to the victim. They will be the ones who will be able to notice changes in behavior and other indicators that cannot be measured.

Concussion is not the only complication of traumatic brain injury. As a result of the blow, a person may develop intracranial hematomas, foci of cerebral infarction (death of brain tissue), and if there is a fracture of the skull bones, their fragments can also injure intracranial structures. That is why one interview with the victim and his relatives is not enough to accurate diagnosis. Doctors resort to instrumental and laboratory methods, such as:

• to detect fractures;
• magnetic resonance imaging, which allows you to see the smallest disturbances in the structure of the brain;
• Ultrasound, which visualizes possible displacement of the brain as a result of a growing hematoma;
• lumbar puncture - with its help, an admixture of blood is detected in the cerebrospinal fluid, which also indicates hemorrhage between the membranes of the brain.

Treatment

Neurologists or neurosurgeons treat traumatic brain injuries. It often happens that after a few hours a person who is practically healthy in appearance suddenly falls into a coma due to an illness that was not detected in time. intracranial hematoma. Any patient with a suspected concussion is hospitalized for observation. Measures primarily consist of ensuring rest for the victim, prescribing analgesics to eliminate headaches, drugs that reduce intracranial pressure, if necessary - anticonvulsants and sedatives, medications for dizziness.

In the presence of hemorrhages in the cranial cavity, craniotomy is performed. During this operation, the blood is removed and the wound is sutured. In the case of a hematoma this is - the only way give a person a chance to survive.

Damage to the blood vessels of the neck and skull

The brain is one of the most demanding organs in terms of blood supply. It is no coincidence that cardiac arrest leads to its death in just 5 minutes, while skin cells, for example, can survive more than 6 hours after a complete cessation of nutrition.

Damage to the arteries supplying the brain inevitably affects its blood supply, and first of all this is manifested by unilateral or bilateral constant headaches, often not responding to the use of sufficiently strong painkillers.

Treatment

Inflammatory lesions of the vessels of the central nervous system are usually treated with precisely measured doses hormonal drugs and cytostatics. In case of vascular dissection, an operation is performed to introduce a vascular prosthesis at the site of vessel damage. Without treatment, a person suffering from such diseases is doomed.

Intracranial hypertension (ICH)

This syndrome can develop due to many diseases:

• brain injuries;
• tumors;
• endocrine diseases;
• intracranial infections.

Its cause is a deterioration in the outflow of cerebrospinal fluid from the cranial cavity during its normal production or an increase in its synthesis with adequate outflow. This is due to the appearance of barriers to the outflow path in the form of scars (after injury), tumors, hypervitaminosis A, brain development abnormalities, etc. The headache is constant, its intensity varies from mild to unbearable, vomiting(usually in the morning), occurs mainly at night and in the morning. In parallel with this, there is a decline in performance, nervousness, and instability. blood pressure, a feeling of heart failure, sweating and other vegetative symptoms.

Suffering people become weather-sensitive, their health worsens, predicting a change in the weather.

Treatment

First of all, of course, it is necessary to treat the condition that led to ICH: infection, tumor, concussion, etc. However, in some cases you have to deal with this syndrome itself. For this purpose, diuretics are used to enhance the absorption of cerebrospinal fluid into the blood and its excretion.

In mild cases they are sometimes limited non-drug methods- correct drinking regime, manual therapy, massage, physical therapy. In cases of severe ICH, it may be necessary to install a bypass for the outflow of cerebrospinal fluid into the canal. spinal cord, if the main path is insurmountable.

Brain tumors

With brain tumors, headache is highly variable. It often resembles a tension headache, but can differ in both location and intensity. This symptom occurs in 17% of cases of all oncological pathology of the brain, regardless of whether the primary tumor is located in it or it is a metastasis of cancer of another organ.

Squeezing extensive education brain structures leads to the development of intracranial hypertension and hydrocephalus, in which the headache is widespread throughout the head and is most severe in the morning. After a few hours it subsides, unlike a tension headache.

When nerve centers are compressed, symptoms corresponding to damage to a particular nerve also arise - paresis, local or generalized paralysis.

Treatment

Like any oncological pathology, brain tumors are treated with radiation, radiotherapy and chemotherapy. In some cases, microsurgical operations are used to remove a space-occupying lesion. Elimination of the tumor or reduction in its size often leads to the disappearance of headaches.

Intoxication with substances and their withdrawal

Many substances cause headaches upon contact with them. Poisoning carbon monoxide, arsenic, alcohol, drugs, histamine, etc., can cause diffuse headache, sometimes not relieved even by strong analgesics. Some drugs may also have side effect in the form of a headache.

There is an abuse headache that occurs due to the abuse of painkillers. In this case, there is a kind of paradox - taking analgesics, instead of reducing headaches, contributes to their intensification after a short period of relative well-being.

Finally, sometimes headaches are caused by drug withdrawal. “Withdrawal” is common when trying to stop drinking coffee. The headaches are constant, moderate, and usually disappear without a trace a few weeks after quitting caffeine.

Treatment

In case of poisoning with toxic substances, drugs, alcohol, detoxification measures are carried out. In case of drug abuse, treatment is carried out by stopping the drug that caused the disease. For withdrawal headaches, the approach to withdrawal from the drug in question should be modified. It is necessary to “jump off” from it gradually, gradually reducing the dose. In this way, the body adapts to changed circumstances and has time to produce internal painkillers.

Intracranial infections

And encephalitis - these two scary words known to many. The headache in some forms of these diseases is so monstrous that even adults turn into crazed creatures writhing from it. In small children it causes a continuous monotonous cry. The nature of the pain is bursting, pressing, it usually covers the entire head.

Treatment

Depending on the microbe that caused the disease, antibiotics are used, antivirals, drugs that improve cerebral circulation and the outflow of cerebrospinal fluid, painkillers and glucocorticoids.

Infections of cranial structures

, - this is the most common cause of headaches when the structures of the skull are damaged.

Ethmoiditis is inflammation of these paranasal sinuses nose is accompanied by a moderate, constant, debilitating headache that only partially responds to analgesics. This pain is associated with irritation by the inflammatory process cranial nerves, which transmit impulses to the pain centers of the brain.

Treatment

At chronic inflammation structures of the facial skull, antibiotics, anti-inflammatory and painkillers are used. For sinusitis, the doctor can perform a puncture of the corresponding sinus and even a full-fledged operation. Painful sensations subside as inflammation disappears in the corresponding organ.

Headache is one of the most common clinical signs many diseases. Even a simple classification of different headaches takes up 9 pages of small text. Obviously, identifying the cause of this symptom on your own is extremely difficult. Simply taking pills “for the head” is just a “crutch” that does not cure, but temporarily postpones an acute phenomenon. And what needs to be treated is not the symptom, which is a headache, but the disease that provoked its appearance. And here better than a doctor no one can handle it.

DIAGNOSIS- DIAGNOSIS, DIAGNOSTICS (from the Greek diagnosis recognition). The word diagnosis refers to all those actions and reasoning, with the help of which the individual picture of the disease is reduced to the symptoms and characteristics of the body, known to science given... ... Great Medical Encyclopedia

diagnosis- make an action make a diagnosis make an action correct diagnosis action put accurate diagnosis action to diagnose action...

One of the most common diseases to diagnose. Karl Kraus We don't know what we live for; and doctors also don’t know what we’re dying from. Henryk Jagodzinski Our diseases are still the same as thousands of years ago, but doctors have found more for them... ... Consolidated encyclopedia of aphorisms

Make a diagnosis.. Dictionary of Russian synonyms and similar expressions. under. ed. N. Abramova, M.: Russian dictionaries, 1999. diagnosis noun, number of synonyms: 3 conclusion... Synonym dictionary

put- question put action business put organization diagnosis put action task put existence / creation put matter organization put question action put voice change, positive put date... Verbal compatibility of non-objective names

A definition of a disease made by a doctor based on certain signs. Complete dictionary foreign words, which have come into use in the Russian language. Popov M., 1907. DIAGNOSIS, recognition of a disease, determination of its quality by one or another sign.... ... Dictionary of foreign words of the Russian language

DIAGNOSIS, huh, husband. Medical report on health status, definition of illness, injury based on special research. Deliver d. Clinical d. Preliminary, final d. | adj. diagnostic, oh, oh. Dictionary… … Ozhegov's Explanatory Dictionary

- (foreign language) to determine, to draw a conclusion (a hint of a diagnosis, a definition of a disease) Wed. Who has no hope? Now that I diagnose myself and treat myself at times, I hope that my ignorance is deceiving me, that I am wrong about... ... Michelson's Large Explanatory and Phraseological Dictionary

To make a diagnosis (foreign word) to define, to draw a conclusion (a hint of a diagnosis, a definition of a disease). Wed. Who has no hope? Now that I diagnose myself and treat myself at times, I hope that my... ... is deceiving me. Michelson's Large Explanatory and Phraseological Dictionary (original spelling)

A; m. [from Greek. diagnosis recognizable] Determination of the essence and characteristics of the disease based on a comprehensive examination of the patient. Put d.D. was not confirmed. There is no diagnosis yet. ◁ Diagnostic (see). * * * diagnosis (from Greek diágnōsis ... encyclopedic Dictionary

Books

• Analysis decoding. How to make a diagnosis on your own, Anton Vladimirovich Rodionov. The fourth book of the "Academy of Health" is devoted to the discussion modern methods laboratory diagnostics. Readers who like to be examined or are forced to do so due to their...
• Decoding tests: How to make a diagnosis on your own, Rodionov A.V.. Decoding tests How to make a diagnosis on your own The fourth book of the Academy of Health is devoted to a discussion of modern methods of laboratory diagnostics. Readers who love...

YOUR CORRECT DIAGNOSIS

The most important thing in medical treatment is to identify the cause that destroys human health. The doctor, together with the patient, needs to establish, identify, and find the “criminal.” If it is clear which disease is causing suffering, then there is clarity in treatment. Once the diagnosis is made, further action is easier. But making a correct diagnosis is not only the most important thing in clinical medicine, but also the most difficult. Despite the achievements of modern medicine, the emergence of expensive diagnostic systems, despite all the efforts of medical workers, unfortunately, it often happens that we fail to catch the “criminal”. When there is no accurate, correct diagnosis, the doctor has to act blindly, and the treatment prescribed in such situations often turns out to be ineffective.

Sometimes a person’s illness is so difficult that sometimes even the pathologist at the section after fatal outcome, having the opportunity to look into any corner of the body, cannot say what the person was sick with. Sometimes the pathologist, who is the last resort, cannot make the correct final diagnosis. The cause of death in such situations is established as the most probable.

An experienced clinician differs from a less experienced one in that the less experienced one gets the greatest job satisfaction when he cures a patient. More experienced doctor He also rejoices at the recovery of the big man, but he experiences the greatest satisfaction when he makes the correct diagnosis of a difficult patient, when he catches the “criminal” and “puts him behind bars.”

The overwhelming majority of patients are convinced that making a correct diagnosis is the responsibility of doctors alone. They are sure that absolutely nothing depends on them here. This typical mistake, an unfortunate misconception.

If the doctor and the patient work together on the diagnosis, the diagnosis becomes more accurate and correct.

What can a patient who does not have medical education, what should be done to ensure that the diagnosis is made correctly?

First of all, he must include himself in the team of medical professionals who care for him. He must become a full-fledged, full-fledged partner, a member of the team, he must play active role in the diagnostic and treatment process, and not to be a passive observer. The quality of information and the accuracy of the data on the basis of which the doctor makes a diagnosis depend on the patient. How correctly the patient can convey to the doctor what is happening in his body, the correct his diagnosis will be. If these data are crooked, so will the diagnosis. It has already been noted that uncertainty is part of medicine. The patient can reduce this uncertainty.

In previous chapters, I have already dwelled in detail on what and how the patient should give to the doctor so that the doctor makes a full, correct diagnosis. Here I deliberately used the verb “to give”, realizing that the phrase can be interpreted in two ways. Provide accurate, objective, complete information about your disease and yourself. No one knows your body and the peculiarities of its reactions better than you. Only you know what is most important to you. As noted, the doctor cannot feel the disease for you. The doctor only helps convey to the patient the manifestations of the disease. Being clear about what is happening to you is very important. Sometimes this is difficult for the patient to do. Most often, patients give either too little information or overload their speech with details that are completely irrelevant.

It is necessary for the patient to strive for clarity of presentation, since the correctness of the diagnosis depends on it.

After the doctor has analyzed the data received and told you your diagnosis, ask on the basis of what data he came to this conclusion. Let him convince you that you have exactly the disease he is talking about. In the vast majority of cases, this can be done in two or three simple sentences. If the doctor speaks firmly and in words that you understand, the “criminal” is caught. If you see doubts, hesitations, dissatisfaction, and sometimes verbosity of a conscientious, competent, experienced doctor, then the diagnostic search may have to be continued. Here, without even delving into the meaning of what was said, but by the way the doctor answers your question about the reliability of your diagnosis, you can judge with a high degree of probability its validity.

Quiet confidence is what an intelligent patient should see from his doctor, asking him to reassure him of the correctness of his diagnosis.

If you are a “complicated case” and are diagnosed as most likely, do not hesitate to ask your doctor what other diseases may cause these symptoms. This will help the doctor take a broader look at the problem, “cast the net” more widely, and extra work By differential diagnosis, be more creative. Let his thought process, his “agony” when making a diagnosis, be in front of you. This will allow you to get involved in the search process. Ask your doctor what else you can do to confirm the diagnosis. What should be your next steps to catch the “criminal”.

An important and well-proven technique for difficult diagnoses is a second opinion. If you are given the most likely (approximate) diagnosis and it is not completely clear what exactly is happening to you, it is advisable to consult another doctor. This does not mean that the first doctor is bad. Clinical medicine consists of uncertainties. Different doctors have different experiences, different schools, they think differently. It may well be that the second doctor already had a patient with similar problems which he managed to solve. The second doctor may turn out to be more “corrosive” or more interested in this branch of medicine. IN difficult situations Third and fourth opinions are not excluded. According to American doctors, a second opinion changes diagnostic and treatment tactics in 1/3 of cases! A good clinician will never be offended if you tell him that you want to see another doctor.

For particularly difficult diagnoses, it is advisable to consult with specialists of a narrow profile who have great experience. As a rule, in such cases, the patient should contact large medical research centers that specialize in certain areas of medicine. It is best for the patient to search for such centers together with his or her attending physician. Sometimes the problem can only be solved in our capitals, and sometimes only abroad.

Monitor your body's reactions. Be proactive if your prescribed treatment doesn't help or if you feel worse. Let your doctor know about this. There should be a strong communication between you and your doctor. In such a situation, do not try to complete the entire prescribed course of treatment or complete it. This may be because you are being treated for another illness. It happens. Find out with your doctor the reason why treatment is not working. Perhaps it is too early to expect improvement, and the deterioration is due to the work of the drug. Or perhaps your diagnosis is incorrect and you should continue your diagnostic search.

In our country, there are few organizations that actually protect the rights of patients, and there are no structures at all to help patients get involved in the diagnostic and treatment process. In this regard, our patients must be much more active than, say, in developed countries, where such structures exist. For now, everything is the other way around.

Medical professionals in Western countries are better trained, more motivated, better equipped, but their patients, who might seem like they could relax, are much more active than ours. That's why people in the West live longer.

Understanding that much depends on the patient in identifying the disease gives him the opportunity to live longer.

Your correct diet The general term “cancer” refers to malignant neoplasms. It must be taken into account that the manifestations of each of them are different. In this regard, it is impossible to talk about general diet for all cancer patients, should be taken into account