Assalamualaikum readers!!
YAHHOOOO!! Officially aku dah habis end posting exam untuk medical. Penatnya study last minute and end up padan muka aku dapat soalan yang susah gila bab! By the way, aku tak nak cakap pasal performance aku untuk exam baru-baru ni sebab takda mood nak cerita. Next time aku story- mory kat korang suma.
See!! the topic hari ni...tajuknya pasal " pulsatile mass" dan aku.
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| Whats going to happen next?? |
Suspens dowh especially bagi budak-budak noob medical student macam aku. Pulsatile mass kalau korang jumpa kat mana-mana pun bahaya sangat aku nak cakap. Bahasa masyarakat senang cakap boleh meletup dan babai lah dunia. Sayonara~~
Aku presenting my really own authentic case, 25 years old Malay lady, single (wuhuuu.....), no known medical illness presented with 1 week history pulsatile mass over the scalp. To be exactly, at the right parietotemporal area associated with mild unilateral headache. No weakness or loss of vision. On examination, uneventful, no bruit heard.
Apa diagnosis korang?
MENGADE!!
Seriously, sebelum nih memang aku dah rasa pulsatile sensation tu cuma tak la besar sangat, but recently dah besar betul! Risau gila aku, dah bermacam-macam differentials came out and seriously apa yang aku browse through Mr. Google memang seram like he said " You are going to die soon~~" I'm not afraid of dying but I have a lot more that I want to achieve.. GRADUATE PUN BELUM!! KAHWIN?? sedih bila fikir...
So, at the same time, aku on preparation for this exam yang stress nak mampus, so aku fikir after exam je terus aku nak pergi check up kat primary care clinic IIUM. Tapi korang cuba la bayangkan, boleh ke nak study sambil risaukan that damn "mass". Memang tak la kan??
Sampai-sampai aku siap bukak Googlescholar untuk browse pasal SCALP ANEURYSM!! Tapi mostly patient memangla ada long history of pulsatile mass, siap tortuous penuh satu kepala. Aku punya takda la sampai macam tu sekali. Cikonet je TETAPI kecik-kecik pun still la kan kena risau!
List differential aku~semua dasyat-dasyat okeh!!
1. Scalp aneurysm
| takdela sampai tahap macam nih!! |
2. Scalp AVM
3. Giant cell arteritis
Aku ada baca satu journal on management of scalp aneurysm done in India. 8 patient presented. Result form endovascular surgery, 7 uneventful but 1 DIED due to cerebral edema tapi sebab eneurysm dia secondary cause.Hopefully not in my case.
Yang pasal giant cell arteritis, there was a case 19 years old lady, presented with pulsatile mass and headache foe 1 month.Clinically was normal and removal surgery done. They sent biopsy for that and ended up to be giant cell arteritis.
Oooomaiiiiigadddd!!
Relax babe!!
Senang la kau cakap relax! Cer rasa tengok! Bercakap memang senang tapi kalau sendiri yang dapat memang wassalam la ye~~
Continue story aku, after exam medical habis semalam, terus besok tu aku pergi ke PCC IIUM nak dapatkan treatment yang sepatutnya.
Cik Nursyahirah?
Ye saye....
Masuk bilik 1 kayh...
Tup tap...tup tap...saspens sikit ehh~~
Assalamualaikum (Eh! aku kenal doc neyh, doc postgraduate fammed )
Ade apa masalah?
Dgn sedihnya, DR.........saya ada pulsatile mass DR dekat kepala. (Muka memang macam nak nangis!!)
Hahaha...nih bukan mass la, vessel nih... (Okay, aku rase bodoh tetiba tapi bukan ke sama je..)
Tapi, DR saya ada headache belah left sided plus rasa macam tarik mata belah kiri nih...
Okayyyy...so awak fikir apa? aneurysm?
Aku angguk-angguk kepala laju ja...(ye la DR!)
Ye la tapi awak punya dahla kecik je, baru seminggu kan?
(Dalam hati, kalau kita found awal and treat awal lagi bagus kan, supaya mortality rate pun turun..., tapi siapa la aku nak berlawan kata-kata, telan je la)
Selain tu DR, saya rasa maybe nih giant cell arteritis, even though not like typical presentation tapi saya found one article on that case similar like me...
Okayy!!! Haha.. (DR gelakkan aku....sedih mak)
DR tanya soklan aku macam nak exam pulak!!
So how you want to diganose GCA?
Aku blur? ESR?
Nope, its just to monitor kan~~ MRA la dik!! So awak nak ke saya refer awak untuk MRA?
Err....takpela DR, saya observe dulu la... (MRA? That is so damn serious thingy!)
| Sekadar hiasan~~ |
MALU NAK MAMPUSS!! Ake realize that time yang aku ada HYPOCHONDRIASIS!!
Aku nak blah cepat-cepat, malu dowh!! Sorry DR for bothering your time!
Its okay, dah banyak kali dah ~~~
Dalam pada macam tu pun aku, still risau weyh!! sebab kecik bagi dia , gedabak bagi aku...
That the end of my "mass".
Nak sleep sebab penat study group!!
Till then with love!!
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