Cerebrovascular disease is characterized as a group of diseases, conditions, and disorders which ultimately affects the blood vessels and the blood supply to the human brain. Brain damage can occur when a blockage, malformation, or hemorrhage prevents the brain cells from receiving enough oxygen. Cerebrovascular disorders can include stroke, transient ischemic attack or TIA, aneurysm, and vascular malformation. �
Cerebrovascular disease can develop due to a variety of health issues, such as atherosclerosis, where the arteries become narrow; thrombosis or embolic arterial blood clot, which is a blood clot in an artery of the brain; or cerebral venous thrombosis, which is a blood clot in a vein of the brain. �
In the United States, cerebrovascular disease is one of the most common causes of death. In 2017, it caused about 44.9 deaths per 100,000 individuals or 146,383 deaths in total. Fortunately, people can decrease their risk of developing cerebrovascular disease. In the following article, we will describe the types, the symptoms, the diagnosis, and the treatment for cerebrovascular disease and how to prevent them. �
Cerebrovascular Disease Symptoms
The symptoms of cerebrovascular disease are commonly based on the region of the health issue and its effect on the brain. � Different types of cerebrovascular disease may have different symptoms, however, common symptoms can include: �
a severe and sudden headache
hemiplegia or paralysis on one side of the human body
weakness on one side, also known as hemiparesis
confusion
difficulty communicating, including slurred speech
losing vision on one side
loss of balance
becoming unconscious
Emergency Response
The American Stroke Association promotes the public knowledge of the F.A.S.T. acronym as a way to help people recognize the warning signs of a stroke or any other type of cerebrovascular disease to take action immediately, including: �
face drooping
arm weakness
speech difficulty
time to call 911
Immediate medical attention is fundamental if anyone demonstrates symptoms of a cerebrovascular disease attack because these may ultimately have long-term effects if not treated immediately, such as cognitive impairment and paralysis. �
Types of Cerebrovascular Disease
Stroke, TIA, and subarachnoid hemorrhage are several types of cerebrovascular disease. Aneurysms and hemorrhages may cause acute health issues. Blood clots can affect the brain directly or indirectly from other regions of the human body.
Ischemic Stroke
Ischemic strokes occur when a blood clot or atherosclerotic plaque blocks a blood vessel which supplies blood to the brain. A clot or thrombus may develop in a narrow artery. A stroke occurs when a blood supply deficiency causes brain cell death.
Embolism
An embolic stroke is the most common type of ischemic stroke. An embolism occurs when a clot breaks off from another region in the human body and travels to the brain and blocks a smaller artery. People who have arrhythmias, which are health issues associated with irregular heart rhythm, are more vulnerable to developing an embolism as well as other health issues. �
A tear in the lining of the carotid artery, which is found in the neck, can ultimately cause an ischemic stroke. The tear allows blood circulation to flow between the layers of the artery, reducing blood flow to the brain, and causing it to become narrow. �
Hemorrhagic Stroke
Hemorrhagic strokes occur when a blood vessel in part of the brain weakens and pops open, causing blood to flow into the brain. The leaking blood puts pressure on the brain tissue, causing edema, which can ultimately damage brain tissue. The hemorrhage may cause parts of the brain to lose their supply of oxygen-rich blood, causing a variety of other health issues. �
Cerebral Aneurysm or Subarachnoid Hemorrhage
A cerebral aneurysm or subarachnoid hemorrhage can occur due to structural health issues associated with the blood vessels of the brain. An aneurysm is a bulge which in the arterial wall which may rupture and bleed. A subarachnoid hemorrhage occurs when a blood vessel ruptures and bleeds between two membranes in the brain, damaging brain cells. �
Cerebrovascular Disease Causes
Cerebrovascular disease develops due to a variety of factors. If damage occurs to a blood vessel in the brain, it won’t be able to deliver enough or any blood to the necessary region of the brain. The deficiency of blood can affect the delivery of oxygen and brain cells can begin to die. Brain damage is irreversible. �
Immediate medical attention is fundamental to decrease a person’s risk of long-term brain damage and increase their chances of survival. Atherosclerosis is a key cause of cerebrovascular disease. This occurs when cholesterol levels, as well as inflammation in the brain’s arteries, cause cholesterol to build-up. This plaque may restrict or completely obstruct blood circulation into the brain, causing a cerebrovascular disease attack, including a stroke or TIA. �
Risk Factors
Stroke is the most common type of cerebrovascular disease. The risk of stroke increases with age, especially if a person or their close relatives have previously had a cerebrovascular disease attack. The risk doubles every 10 years, between 55 and 85 years of age. However, a stroke can occur at any age, even during infancy. � Factors which increase the risk of stroke and other types of cerebrovascular disease include: �
hypertension, which the American College of Cardiology defines as blood pressure of 130/80 mm Hg or higher
smoking
obesity
poor diet and lack of exercise
diabetes
blood cholesterol levels of 240 milligrams per deciliter (mg/dl) or higher
The same factors can increase a person’s risk of developing a cerebral aneurysm. However, people with a congenital anomaly or previous head trauma may also be at risk of developing a cerebral aneurysm. Pregnancy can also increase the risk of developing cerebral venous thrombosis which is a blood clot affecting a vein in the human brain. � Other risk factors of cerebrovascular disease include: �
Moyamoya disease, a progressive condition which causes a blockage of the cerebral arteries and their major branches
venous angiomas, which affect around 2 percent of the U.S. population and rarely bleed or cause symptoms
a vein of Galen malformation, an arterial disorder which develops in a fetus during pregnancy
Certain drugs and/or medication, as well as other health issues, can make the blood more likely to clot and also increase the risk of ischemic stroke. Hormone replacement therapy or HRT may also increase the risk of a cerebrovascular disease attack in people who currently have atherosclerosis or carotid artery disease, among other health issues. �
Cerebrovascular Disease Diagnosis
Any cerebrovascular disease can be considered a medical emergency and anybody who recognizes the symptoms must contact 911 for support and evaluation. Early diagnosis is fundamental to reduce brain damage. In the clinic, a doctor will ask about the person’s medical history and search for specific neurological, motor, and sensory health issues, including: �
changes in vision or visual fields
reduced or altered reflexes
abnormal eye movements
muscle weakness
decreased sensation
A doctor may also utilize a cerebral angiography, vertebral angiogram, or carotid angiogram to identify a vascular abnormality, such as a blood clot or a blood vessel health issue. These include injecting dye to demonstrate any clots as well as their size and form on MRI or CT imaging. �
A CAT scan will also help a doctor diagnose hemorrhagic strokes as it can distinguish between blood, bone, and brain tissue. However, it does not reveal damage from an ischemic stroke in the first phases. An MRI scan may detect early-stage strokes. An electrocardiogram (EKG or ECG) may diagnose cardiac arrhythmia which is a risk factor for embolic strokes. �
Cerebrovascular Disease Treatment
A cerebrovascular disease requires emergency treatment. Rapid diagnosis and treatment are crucial because a person must receive stroke drugs and/or medications from the beginning of their symptoms. In the case of an acute stroke, the emergency group may administer a medicine known as tissue plasminogen activator (tPA) which breaks up the blood clot. �
A neurosurgeon must evaluate a person who has had a brain hemorrhage. They may perform surgery to decrease the pressure which bleeding causes in the brain. A carotid endarterectomy involves making an incision in the carotid artery and removing the plaque. This allows blood to flow again. The surgeon then repairs the artery with sutures or a graft. �
Several patients may need carotid angioplasty and stenting which involves a doctor inserting a balloon-tipped catheter into the artery so that the artery reopens when they inflate the balloon. Then, the doctor matches a slim, metal mesh tube, or stent, within the carotid artery to improve blood flow in the formerly blocked artery. The stent helps to prevent the artery from closing-up or collapsing following the procedure.
Cerebrovascular Disease Rehabilitation
Because a cerebrovascular disease attack can cause irreversible brain damage, people can experience temporary or permanent disability. For this reason, they may require a variety of supportive and rehabilitative treatments so that they can keep as much function as possible. These may ultimately include: �
Physical therapy: The goal is to restore mobility, flexibility, and upper and/or lower extremity function.
Speech therapy: This helps improve communication and regain speech after a stroke or cerebrovascular disease attack.
Occupational therapy: This can help access facilities which support a return to work and daily life.
Psychological therapy: Physical disability can create unexpected emotional demands and often requires intensive readjustment. A person may benefit from visiting a psychiatrist, psychologist, or counselor after experiencing a cerebrovascular disease attack if they feel overwhelmed.
Cerebrovascular Disease Prevention
Techniques and methods which can ultimately help reduce the risk of cerebrovascular disease include: �
no smoking
getting at least 150 minutes of moderate to intense exercise and/or physical activity every week
eating a balanced diet which supports vascular health, such as the DASH diet
maintaining a healthy body weight
managing blood cholesterol and blood pressure with diet as well as drugs and/or medications, if necessary
People with heart arrhythmia should seek immediate medical attention from a healthcare professional and discuss whether they should be taking a blood thinner to prevent strokes. �
Stroke and other cerebrovascular diseases may lead to death but with immediate medical attention, a partial or full recovery is possible. Patients with cerebrovascular disease should follow their healthcare professional’s instructions and lifestyle modifications to ultimately help decrease the prospect of a cardiovascular disease attack. �
Decreasing the Risk of Stroke
Taking blood platelet inhibitors, including, Dipyridamole, Ticlopidine, and clopidogrel, can decrease the chance of stroke before it occurs. These can help prevent stroke in people who have a medical history or higher prospect of experiencing a cerebrovascular disease attack. �
Doctors recommended people to take a daily dose of aspirin to decrease the chance of a heart attack or stroke. However, current guidelines recommend people to take aspirin only if they’re at risk of experiencing cardiovascular disease because aspirin increases the risk of bleeding. � Doctors prescribe statins to manage high cholesterol levels and reduce the risk of ischemic stroke and heart attack. �
As previously mentioned above, cerebrovascular disease is identified as a group of diseases, conditions, and disorders which affects the blood vessels and the blood flow supply to the human brain. There are several types of cerebrovascular diseases and their diagnosis and treatment depends on the type and severity. Prompt treatment and lifestyle modifications can improve the outlook of a patient with cerebrovascular disease. Chiropractors are qualified and experienced to help patients with cerebrovascular disease recover from their symptoms. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
The purpose of the article above is to describe cerebrovascular disease and its effect on overall health and wellness. Neurological diseases are associated with the brain, the spine, and the nerves. The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues as well as functional medicine articles, topics, and discussions. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 . �
Curated by Dr. Alex Jimenez �
Additional Topic Discussion: Chronic Pain
Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance.
Formulas for Methylation Support
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
�
For your convenience and review of the XYMOGEN products please review the following link.*XYMOGEN-Catalog-Download �
* All of the above XYMOGEN policies remain strictly in force. �
Our brain is one of our most important organs that controls everything that we do. From learning how to walk at our earlier stages, learning new motor skills, to remembering nostalgic events in our lives. However, when tragedy strikes, our brain is the first one to get impacted.
The brain has many functions in the past that were structured, fixed, and therefore, hard-wired. That changed in the 1970s when neuroscientists discovered that the brain was the opposite of what they originally thought. It turns out that the brain is continuously changing and gathering information for many life events called neuroplasticity.
Our brain�s neuroplasticity has helped us re-learned simple motor skills by training our bodies to do these functions through rehabilitation from any brain injuries that anyone has been through. However, for some people, when they are recovering from any tragic events can encounter many mental struggles and have a hard time to bounce back. The most common mental struggles are apparently stress.
Good Stress: Increases energy, strengthens the immune system, immune to other stressful situations.
Bad Stress: High blood pressure, mental health problems, weaker immune system.
These two categories can make our brain go into overdrive, however, once you find out what stresses you out; you can actually find many ways to de-stress and relax. Some examples are taking up a hobby to make your brain learn a new technique, while others are either exercising or talking to someone.
When you�re exercise, not only your whole body feels good, but also you can let out whatever is frustrating you when you put the work in. And when you are done exercising for thirty minutes to an hour, you will feel a whole lot better with a clear head. When you�re talking to someone, it feels pretty good to have somebody there to listen to your problems and sometimes they will give you some advice and maybe something to drink so you can feel relaxed a bit and let your worries slip away.
Other times when you want to keep your brain healthy is to eat some really good food. Some of the food we eat have been known to keep our brain�s motor skill running and making your body feel good. Omega-3s, antioxidants, L-theanine supplements are consumed to calm down the neurotransmitters that are in our brain.
Neurotransmitters
This leads to our neurotransmitters, GABA and Glutamate, to be monitored by MRS (magnetic resonance spectroscopy). When these two neurotransmitters are being monitored, doctors have found out that the patient�s glutamate is in overdrive and that they need to increase the patient�s GABA in order to lower the excitotoxicity and protecting the brain�s grey matter or else the brain will get destroyed.
Some of the best ways to ease an anxious mind are to figure out what is causing our brains to be extremely anxious in any situations that are thrown to us. Our brain is like the CPU of a computer that we programmed and managed so we can have these thoughts, passion, and desires that are wired into our minds. The brain is an intricated network of neurons and receptors that co-exist to various internal and external stimulations.
So, if we were to find the �virus� that is causing our brains to be overwork and anxious, we can change our mind to make it mellow out and tell ourselves that we are fine. Our brain has six brainwaves that are well known and here is a very quick outline of what each wave does.
Infra-low: The �reset� wavelength helps our brain slow down and reset our thought process.
Delta: These waves help us go into a deep meditative state.
Theta: These waves benefit our memories, intuition and learning process.
Alpha: These waves make us feel calm and be at a resting state.
Beta: These waves are split into three sections and each section deals with our waking state: Idling, calculated thoughts and learning new experiences.
Gamma: These waves make us have a quiet, calm healthy mind when we need peace and quiet.
The first five brain waves are key for us to have a calm, collected healthy mind when we have to go to sleep. We all know that having 8 hours of sleep is essential for us to have a healthy mind. When we don�t get enough sleep, we feel grouchy or even more tired when we have to get up to go to school or work. So, we have a bit of caffeine to lift our spirits up, and of course, go through the day. Even if we have some time to spare a quick nap for about thirty minutes seems to help our brain process what we learned and then feel refreshed after that nap.
Proper Sleep = Healthy Mind
Like the last paragraph stated, when we don�t get enough sleep, we feel more tired when we have to get up and start our day. However, let�s say someone is very anxious or has depression can suffer from hypersomnia. When a person suffers from hypersomnia, it takes that person�s willpower to actually get up and go out of their bedroom.
What they think is that �I don�t feel well� but; it is actually their brain producing so much glutamate and have less GABA that may be a factor to these triggers. But when we find supplements that can help our brain rewired itself naturally with these supplements that we find in food. As Hippocrates stated, �Let food be thy medicine and let medicine be thy food.�
All in all, our brain is one of the most valuable organs that we must take care of. Whether it be taking up a new hobby, going to eat some good food to fuel our brain cells and protect it at the same time, or even finding a quiet place to meditate. We have to have to make sure our brain�s neurochemistry is doing okay and that it is healthy enough to experience new things that we encounter throughout our lives.
El Paso, TX Neck Pain Chiropractic Treatment
Sandra Rubio discusses the symptoms, causes, and treatments of neck pain. Headaches, migraines, dizziness, confusion, and weakness in the upper extremities are a few of the typical symptoms. Trauma from an accident, such as that from an automobile accident or a sports injury, or an aggravated illness because of improper posture can commonly cause neck pain and other ailments. Dr. Alex Jimenez uses spinal alterations and manual manipulations, one of other chiropractic treatment techniques like deep-tissue massage, to reestablish the alignment of the cervical spine and improve neck pain. Chiropractic care with Dr. Alex Jimenez is your non-surgical choice for restoring general patient well-being.
Neck pain is a frequent health issue, with roughly two-thirds of the people being influenced by neck pain at any time throughout their lifetimes. Numerous other health issues can cause pain arising in the upper back, or the spine. Neck pain can result emanating from the vertebrae, or because of muscular tightness in both the neck and the upper back. Joint disruption in the neck causes migraines, and headache, as does joint disturbance at the trunk, or can generate a variety of other symptoms. Neck pain affects about 5 percent of the worldwide population as of 2010, based on figures.
NCBI Resources
The relationship between the body and the mind is still far from being fully understood. However, there is no denying the significant connection between our physical health and our mental health. When your body is healthier, your mood is more level and positive. Just like keeping a food diary can help you identify a food allergy, keeping an anxiety diary can help you see what things in your life are triggering your anxiety. Triggers for anxiety�can include a wide range of things, not all of them related to human interactions. All for a healthy mind!
Children are not born with a fully developed microbiome, and a baby’s diet has a large impact on the foundation set for a healthy guts future (Biotics Education Team, 1).� Setting up a child to have healthy gut flora from early stages can help them:
In the TEDDY study published in Nature Medicine, it shows that a child’s microbiome goes through 3 transitional phases:
Developmental phase (3�14 months)
Transitional phase (15�30 months)
Stable phase (31�46 months)(Stewart et al., 3)
Throughout the developmental stage, those with a higher breastfeeding rate were associated with increased levels of Bifidobacterium.� “However, once the infants were weaned, there was a rapid loss of the�Bifidobacterium spp.,�and a quick turnover occurred in the microbiome, which featured a higher population of bacteria within the�Firmicutes�phylaphase (Biotics Education Team, 1)”.� Once infants begin to wean off milk, it is helpful to start providing them with probiotic powders.
Prebiotics are the dietary fiber that the live organisms in the probiotics need to eat in order to flourish.
Some foods that include prebiotics are:
Vegetables
Fruits
Legumes
It is great to start toddlers on prebiotics and probiotics because it can help them to continue to have a healthy gut. A healthy gut can help prevent many issues that adults face later on in life (Veereman-Wauters, 4) Having a healthy gut can help to protect the gut from harmful bacteria and fungi, it can aid in sending signals to the immune system, regulate inflammation, create a supportive barrier in the cell lining of the colon and reduce the risk of cancer (Lewis, 2)�
Probiotics are safe for most children and can reduce the risk of upper respiratory tract infections and well as helping to reduce their risk of allergies. It is beneficial to have toddlers on probiotics and prebiotics so they do not develop a “leaky gut”. By starting children on probiotics and prebiotics young, it can aid their overall health for life.
ProbioMax� for Toddlers
Prebiotic and Probiotic Support for Toddlers*
�Overall, it is best to start building the child’s microbiota through the maternal diet in pregnancy, expose them to environments, and talk with their pediatrician about starting them on probiotics. It’s better to start young and build a healthy foundation than to be diagnosed in their 20’s with leaky gut from something that could have been prevented. – Insight from Kenna Vaughn, Health Coach�
NCBI Resources:
Our knowledge of microbiota is rapidly developing and changing. A relatively young field, the science of gut bacteria has been quickly taken up by industry. Most drugstores sell probiotics in some form or another, and yogurt and other fermented foods are frequently hailed as healthy for the gut because they contain live bacteria. Probiotics are food or supplements that contain living microbes intended to support or improve your microbiome’s health. If your favorite yogurt contains �live and active cultures,� you are getting a dose of probiotics along with your breakfast. These microbes are thought to bolster or replace the bacteria communities in the gut of people.
�Cites:
Biotics Education Team. �Impact of Diet on Baby’s Microbiome.� Biotics Research Blog, blog.bioticsresearch.com/impact-of-diet-on-babys-microbiome.
Lewis, Sarah. �Probiotics and Prebiotics: What’s the Difference?� Healthline, Healthline Media, 3 June 2017, www.healthline.com/nutrition/probiotics-and-prebiotics.
Stewart, Christopher J., et al. �Temporal Development of the Gut Microbiome in Early Childhood from the TEDDY Study.� Nature News, Nature Publishing Group, 24 Oct. 2018, www.nature.com/articles/s41586-018-0617-x.
Veereman-Wauters, Gigi. �Application of Prebiotics in Infant Foods.� The British Journal of Nutrition, U.S. National Library of Medicine, Apr. 2005, www.ncbi.nlm.nih.gov/pubmed/15877896.
Gloria experienced considerable foot pain which extended throughout her entire body. Her plantar fasciitis developed due to her everyday physical activities. Gloria describes how her foot pain and plantar fasciitis affected her quality of life. The custom foot orthotics provided to her by Dr. Alex Jimenez, a chiropractor in El Paso, TX, tremendously helped improve her foot pain and plantar fasciitis symptoms. Gloria describes how much comfort the custom foot orthotics provided for her painful symptoms. Gloria highly recommends Dr. Alex Jimenez as the non-surgical choice for foot pain and plantar fasciitis treatment, among other health issues.
Treat *PLANTAR FASCIITIS & FOOT PAIN* with Orthopedic Foot Orthotics | El Paso, TX (2019)
This condition affects approximately 2 million people in the United States a year.
There are doctors that believe bone spurs are the cause, and surgery is needed. However, bone spurs are not the cause of plantar fasciitis. Surgery will not eliminate the pain but may weaken or even rupture the plantar fascia
Symptoms
Pain on the bottom of the heel
Pain in the arch of the foot
Pain that is usually worse upon arising
Pain that increases over a period of months
Swelling on the bottom of the heel
Causes:
Improper footwear
Strenuous activity
Obesity
Over-pronation
High arches or flat feet
Poor shock absorption shoes
Plantar fasciitis is commonly seen in middle-aged patients.
We also see it often in those who place a great deal of stress on their feet like:
Runners
Athletes�
Soldiers
We are blessed to present to you�El Paso�s Premier Wellness & Injury Care Clinic.
We Are Ready To Help You Get Back To Your Normal Life!
How Chiropractic Helps Plantar Fasciitis
Chiropractic care is a very effective treatment for plantar fasciitis as well as the pain that is caused by the condition. Chiropractic for plantar fasciitis involves a very precise technique that involves adjustments to the feet and ankles as well as spinal alignment. This provides several benefits.
Reduces Stress in the Plantar Fascia�� When a ligament is inflamed or stressed the tissue can develop very small tears that cause the pain of plantar fasciitis. Chiropractic adjustments made to the heel and foot take the pressure off of the plantar fascia, allowing it to relax.
Promotes Healing�� When the stress on the plantar fascia is reduced through these chiropractic adjustments, the foot can begin to heal. The chiropractor may also recommend specific exercises that stretch the ligament and help it heal. They may also advise the patient of lifestyle changes as well as nutritional adjustments that can help with the pain and condition.
Provides Effective Pain Management � Chiropractic is a very effective way to manage pain throughout the body. Spinal adjustments allow better communication between the brain and nerves, allowing the central nervous system to function more effectively. Condition-specific adjustments speak to the root of the problem, not just the symptoms. This means a more effective form of pain management that is longer lasting.
Reduces the Risk of Further Injury�� When a person has a condition like plantar fasciitis, they will often adjust their gait in an effort to avoid the pain. This puts stress on other parts of the body and can lead to back pain, sore joints, strained muscles, and other problems. Chiropractic�s�whole-body approach�helps the person realign their body properly so that they stand and walk properly. This helps them avoid further injury and discomfort.
Foot Levelers Kiosk
The Kiosk helps guide patients in selecting the best custom-made orthotics for their condition and lifestyle. It’s�
Fast:�Push the Start button and the scanner begins.
Easy to use:�User-friendly easy touch screen.
Engaging:�Videos explain the importance of healthy feet and the benefits of custom-made orthotics.
Cloud-based:�Results can be securely accessed from anywhere.
Comprehensive:�Easily retrieve previous scans to compare them to new scans and see the difference.
The Foot Levelers Kiosk saves time so you can spend more time living your life.
What’s Afoot
Plantar fasciitis is caused when the ligament that connects your toes to your heel (the plantar fascia) becomes inflamed, swollen, and weak. This causes the bottom of your foot or heel to hurt when you walk or stand, especially when you first wake or after sitting for a long time. The pain tends to be sharp and stabbing. It is the most common�cause of heel pain and is more prevalent among middle-aged people. However, anyone can get it at any age, especially people who spend a lot of time on their feet.
Feet are important. When you consider what your feet go through, taking 8,000 steps over the course of a day, according to the�Illinois Podiatric Medical Association�(IPMA), it�s easy to see how 75 percent of all Americans will have some type of�foot pain�at some point in their lives.�Plantar fasciitis�is a common and very painful foot condition that can become chronic if not treated. It is also a condition that responds very well to chiropractic care.
Cerebral perfusion pressure, or CPP, is the net pressure gradient which carries oxygen to brain tissue. It is measured by the difference between the mean arterial pressure, or MAP, and the Intracranial Pressure, or ICP,� which is measured in millimeters of mercury (mm Hg). Regulating CPP is fundamental in the treatment of patients with intracranial pathology, including shock, hemodynamic distress, and traumatic brain injury. �
Although the average CPP is generally between 60 and 80 mm Hg, these values may change to the left or to the right depending on individual physiology. MAP and ICP has to be measured together because CPP is a calculated measure. Regulating CPP at hemodynamically unstable conditions with abnormal ICP or in cases of intracranial pathology will reduce the chance of ischemic brain injury. �
CPP = MAP – ICP
Cerebral Perfusion Pressure Physiology
CPP and ICP
At its own average range of 60 to 80 mm Hg, the CPP is determined by the ICP and the mean arterial pressure. Under regular standards, the ICP is between 5 and 10 mm Hg which has a reduced effect on the CPP than the MAP in clinical circumstances not associated with intracranial pathology. ICP is generally measured through intracranial pressure transduction.
Physiologically, the ICP is a function of intracranial compliance. Intracranial compliance is the relationship between the ICP and the volume of the intracranial cavity including cerebrospinal fluid, or CSF, brain tissue as well as arterial and venous blood volume. Because the skull is a fixed and rigid anatomic space, the ICP can increase if the intracranial volume increases while intracranial compliance decreases. As the ICP increases or intracranial compliance decreases, CPP also decreases. �
Several processes determine that ICP continues to stay within the average range for the longest extended period of time possible, especially throughout periods of affected intracranial volume and compliance. As volume adds to the intracranial space, CSF can shift into the spinal subarachnoid space, causing the ICP to continue significantly unchanged. As volume increases due to a growing space-occupying lesion, brain tissue edema or blood, this process ultimately becomes overwhelming, and ICP begins to increase substantially. �
Cerebral blood flow, or CBF, is also a fundamental factor in ICP homeostasis. Cerebral auto-regulation makes sure that steady blood flow is maintained in the brain over a wide range of physiologic alterations. When blood pressure decreases, auto-regulation causes cerebral vasodilation and an increase in CBF and cerebral blood volume, maintaining ICP and CPP. However, when blood pressure increases, auto-regulation causes cerebral vasoconstriction and a decrease in CBF with a decrease in cerebral blood volume, also regulating ICP and CPP. Too many changes outside of average CBF ranges can cause brain ischemia and injury. �
CPP and MAP
Because ICP in its average ranges is a considerably small number, the CPP generally depends on the mean arterial pressure. MAP is the normal blood pressure during one cardiac cycle which can be measured through invasive hemodynamic monitoring or calculated by the systolic blood pressure, plus two times the diastolic blood pressure, divided by three. The average range of MAP is 70 to 100 mm Hg. �
The average arterial pressure can be affected due to everyday activities, such as rest, stress, and exercise or physical activities. However, if the ICP continues to stay the same, the average arterial pressure can change across its significantly wide range without tremendously decreasing or increasing the CPP. As a matter of fact, CPP and CBF will continue to stay considerably unchanged across a wider range of MAP (50 � 150 mm Hg) than normal due to cerebral auto-regulation and vasoconstriction or vasodilation of cerebral vasculature. �
For patients with hypertension, the auto-regulation setpoint changes, decreasing the average arterial pressure associated with the patient�s normal arterial pressure, which causes vasodilation to increase CBF. Patients with lower than normal average arterial pressure at baseline will have auto-regulatory vasoconstriction as a reaction to an increase in their significant average MAP, to return CBF to baseline. When looking at CBF and CPP in the context of the patient�s average MAP, it is clinically significant based on the regulation of intracranial pathology and hemodynamic derangements. �
Cerebral Perfusion Pressure Complications
Diagnosing and treating cerebral perfusion pressure complications necessitates measuring both the ICP and the MAP. The MAP may be quantified through the utilization of invasive hemodynamic processes, most frequently cannulation of a peripheral artery such as the radial or femoral artery. The MAP may also be measured with a non-invasive blood pressure cuff by applying the formula mentioned above utilizing the systolic and diastolic blood pressures. � Intracranial pressure is generally measured through an intracranial pressure transduction device. The most common and most accurate method or technique is utilizing an intraventricular monitor. The intraventricular dimension of ICP is the normal standard. An intraventricular catheter is inserted into a hole drilled in the skull and into the lateral ventricle to gauge the pressure of the CSF. The benefit of an intraventricular catheter is that CSF could be eliminated, if needed, to decrease ICP. Considerable complications for the ICP include a possibility of bleeding, infection, and difficulty with proper placement. Options include sub-dural and intra-parenchymal monitors. �
The ICP can be measured non-invasively through several methods and techniques, including transcranial Doppler ultrasonography or TCD. TCD utilizes a temporal window to evaluate the speed of blood flow through the middle cerebral artery. Systolic and diastolic average flow velocity is utilized to determine a pulsatility index. The pulsatility index was determined to be closely associated with ICP in several research studies as well as be associated with ICP in other research studies. Therefore, it is not suggested to use TCD as a substitute for direct ICP dimension. Invasive diagnosis and treatment of the MAP through an arterial cannula and the ICP through an intraventricular catheter will give a continuous and accurate calculation of CPP. �
Cerebral Perfusion Pressure Clinical Significance
Two general types of pathologic health issues can ultimately occur where the regulation of the CPP is fundamental, such as intracranial pathology, where ICP regulation is essential and hemodynamic instability/shock where MAP regulation is the most essential. Intracranial pathology involves space-occupying lesions, such as tumors, epidural and subdural hematoma or severe intraparenchymal hemorrhage and cerebral edema as seen after ischemic injury, traumatic brain injury or acute hepatic encephalopathy. In these circumstances, average CPP depends on decreasing the ICP into a normal range as soon as possible while regulating the MAP. When CPP is normal, it’s fundamental to keep in mind that every individual’s brain tissue has a CPP that is “normal” in the context of that individual patient’s physiology, which may be affected by other health issues, such as hypertension or cardiovascular disease. Moving towards a more dynamic direction of the average CPP utilizing the patient’s personal auto-regulatory capacity. These diagnosis and treatment approaches involve more frequent and sophisticated monitoring and might not be readily available for widespread utilization. �
In the instance of considerable traumatic brain injury, significant cerebral edema can decrease intracranial compliance and CSF, developing an increased ICP or intracranial hypertension. Auto-regulatory mechanisms and techniques may or may not function normally and when ICP continues to be elevated, CPP will decrease causing further injury through an ischemic process. In circumstances such as these, together with starting the measures for decreasing the ICP, it is essential to prevent hypotension (MAP – ICP = CPP) and in some instances, allowing hypertension to reasonably occur. �
In circumstances of instability, the ICP is considerably stable as cerebral auto-regulation is undamaged. In the instance of hypotension, the MAP decreases due to blood loss, or hemorrhagic shock, intravascular leak, or distributive shock, and decreased cardiac output, or cardiogenic shock, and the CPP also decreases. It’s the association between MAP and CPP which carries resuscitation guidelines to recommend regulating a MAP greater than or equal to 65 mm Hg. With a normal ICP, this threshold must make sure that a CPP of 55 to 60, the minimum necessary to stop cerebral ischemic injury, is ultimately maintained. As in the circumstance of ICP and cerebral auto-regulation, the goal of MAP is to be within the context of an individual patient’s evaluation hemodynamic function. Patients with untreated hypertension must have increased MAP goals to maintain proper CBF and CPP. �
As previously mentioned in the following article, cerebral perfusion pressure, or CPP, is the net pressure gradient which affects cerebral blood flow to the brain, also known as brain perfusion. According to healthcare professionals, the CPP, or cerebral perfusion pressure, must be constantly regulated within a specific limit because too little pressure or too much pressure could potentially cause a variety of brain health issues. Cerebral perfusion pressure may be associated with a variety of neurological diseases. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
The purpose of the article is to discuss cerebral perfusion pressure and its association with neurodegenerative diseases. Neurological diseases are associated with the brain, the spine, and the nerves. The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues as well as functional medicine articles, topics, and discussions. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 . �
Curated by Dr. Alex Jimenez �
Additional Topic Discussion: Chronic Pain
Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance.
Formulas for Methylation Support
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
�
For your convenience and review of the XYMOGEN products please review the following link.*XYMOGEN-Catalog-Download �
* All of the above XYMOGEN policies remain strictly in force. �
�Achilles injury, which turns out to be a ruptured Achilles tendon.
This is a devasting injury for anyone, especially world-class athletes. Take NBA player Kevin Durant and his injury that could keep him out for some time. To be fair Durant was dealing with a calf injury on the same leg, for some weeks before this injury.
But it was his first game back in action and it led to a crushing injury!
Calf & Achilles Tendon Relationship
The calf and Achilles tendon are so interrelated that when one has an issue so does the other.
The fascia of these muscles segue ways to form the Achilles tendon.
If the calf is tight, then the Achilles is going to be tight.
The relationship between calf injury and an Achilles injury.
Cycle of Injury
Going through any area of the cycles can lead to a devastating injury.
Symptoms
Pain and stiffness around the lower leg, right above the back of the heel
Begins as a mild ache and worsens throughout the day
Jumping,� running, stair climbing, and sprinting can spark intense pain
Tenderness or stiffness especially in the morning, but improves with movement/activity
The key is to intervene to stop the cycle.
A few ways:
Rest
Massage
Physical Therapy
Chiropractic
Custom orthotics
Active Release Therapy (ART)
ART is extremely�effective�for breaking up scar tissue and improving issues with soft tissues. Treatment can do a lot to improve the health of your tendon and the surrounding tissues to avoid further complications. It will also do a lot to help relieve the pain you are experiencing.
Chiropractic Adjustments/Manual Manipulations
Many times, the issues with your Achilles tendon are the result of misalignment in other parts of your body. When your joints are misaligned it tends to put extra stress on your feet and Achilles tendons. To minimize the stress on your joints, your chiropractor will adjust your spine and other joints to ensure proper alignment.
Get Help for Your Achilles Injury & Call Us Today!
If you are experiencing heel pain, please get in touch with our chiropractic team. We can help to alleviate your pain and help you avoid experiencing further problems with your Achilles tendon.
Difference Foot Orthotics Make to *REDUCE FOOT PAIN* & Correct Posture | El Paso, TX (2019)
Custom made foot orthotics can help control foot motion and posture. Healthcare professionals prescribe custom foot orthotics to help patients focus on their foot posture and mobility control. Research studies have ascertained that using custom foot orthotics for posture and mobility control can help fix excessive foot pronation and supination to prevent a variety of foot health problems. The subsequent video describes how custom foot orthotics will help control foot posture and mobility to improve health and wellness.
What’s Afoot
If you have low back pain�or have had it, you are not alone. Experts estimate that around�80% of people�will experience some type of back problem at some point in their lives.�The Global Burden of Disease 2010�lists low back pain as the number one cause of disability worldwide. The good news is the majority of back pain is mechanical in origin or is not organic. This means that infection, cancer, fracture, inflammatory arthritis, and other serious conditions are not the cause. In fact, you may benefit by looking to your feet, knees,�and hips as the culprits.
NCBI Resources:
The large, thick tendon that travels up from the base of the heel and into the calf muscle is the Achilles tendon. It connects the calf muscle and heel. It allows you to walk, run and jump. The Achilles tendon is strong and durable, but it is possible to overwork it and cause enough overuse injury.
The phrase, �You are what you eat� implies that the way we are defines us as the food we all consumed. However, our gut tells us otherwise as the food we eat, may in fact be leading us to obesity. Our gut plays a role in our overall health, when we eat good food our gut is happy and when we eat bad food our gut will tell us by fighting off the bad food. A recent study showed us that the bacteria in our gut produce amyloid and lipopolysaccharides. These two microbiomes seem to show us that together, with proper dieting that these microbiomes can prevent Alzheimer�s Disease.
As the microbiomes and the bacteria that co-exist in our gut, there are the two most predominant groups that have also played a key role in our lifestyle: gram-positive Firmicutes and gram-negative Bacteroidetes- both play a huge role in obesity. Firmicutes are bad bacteria that lead us to obesity. When we eat processed food and sugars, our body starts to crave it more, thus leading us to be overweight.
Junk Food
When we eat junk food, all that sugar and fat are feeding the Firmicutes. Firmicutes thrive on sugar since our bodies need it and it can be both good or bad While Bacteroidetes are the good bacteria that leads us to a healthy gut. Bacteroidetes are in the stomach regions as well as the Firmicutes. These two predominant bacteria groups tell us that the food we eat can actually affect our bodies when we eat bad foods or good foods.
However, Dr. Kristen Senella mentioned that we all have a different balance of Firmicutes and Bacteroidetes since we are all different shapes and sizes. Depending on our health and food lifestyle, we can have either a low Firmicutes and a high Bacteroidetes or a high Firmicutes and a low Bacteroidetes. Plus, having either a high or low count of Firmicutes can lead to weight gain or weight loss; depending on which healthy lifestyle and exercise regime you are following.
Gram-Positive
Gram-positive bacteria will appear blue or violet, while gram-negative bacteria will appear red or pink under the microscope. When studying the gut and the bacteria groups that it is hosting, scientist use mice to study how their guts react to different diets they are put through so that way we, as humans, can take either pills to help our bodies maintain a healthy lifestyle or to read and do our own research. One group is fed in a healthy lifestyle and doesn�t experience diseases or ailments that we face. And the other group is fed with a bad lifestyle where they are prone to many of the diseases and fatigue as their life span is shortened very quickly. In order for us to actually maintain a healthy lifestyle and importantly feel good is to make sure our Firmicutes are not too dangerously low, but we can control it with probiotics.
Probiotics
Probiotics can vary from yogurt, fermented vegetables, kombucha, and miso. But there are certain companies that also reign supreme in the probiotic market. Activia yogurt and Yakult are two of the most well-known companies that use the live microorganisms to help us maintain a healthy lifestyle as well as keeping our gut�s microbiome in check. When we have some sort of probiotic foods in our system, we are preventing certain ailments and diseases going out of control. Like our cholesterol, blood pressure, being lactose intolerant, or recurring abdominal pains.
When we mix probiotics into our food when we are trying to maintain a healthy lifestyle, we can see a vast improvement in how we have more energy, we feel full that we don�t have to overeat or mindless snacking, and overall we feel good in our gut as we go through our daily routine. From 2007 to now, roughly 3.9 million Americans use probiotics to maintain a healthy gut, however, those probiotics are just a fraction of what the six types of foods that can help maintain a healthy gut microbiome to help support a healthy lifestyle.
Healthy Lifestyle
For instance, a good healthy lifestyle is eating your basic food groups; whether it be plant-based or omnivorous, as well as, exercising a couple of times out of the year. A bad healthy lifestyle is eating processed food and not exercising, which leads to obesity and cardiac arrest. Depending on the person and the efforts that they are willing to maintain a healthy lifestyle, they can achieve longevity by taking care of their gut first and foremost.
Family In Kitchen Making Morning Breakfast Together
Protein
Let�s start with protein. Protein can vary with lean meats like chicken and beef or plant-based like beans, legumes or tofu. Any of these types of protein can help our bodies by making us make our muscles grow, but also control the bacteria in our guts. Next up is fats. Fats can vary like good and bad bacteria. There are good fats like fish, nuts, olive oil, and avocado; as well as, bad fats like butter, lard, and fatty foods. Granted that we can overindulge on the trans fats as there are many fast-food chains, but we can moderate ourselves to not eat out at fast food joints all the time.
Yes, they are cheap and easy to access, however now and days, we as humans are now cooking more in our homes and meal prepping our meals to be healthier. Digestible and Non-Digestible Carbohydrates are mostly starch, sugars, and fibers. These two food groups can make our gut feel happy or upset depending on the food we consume. Sugars, starches, and fibers help our bodies by feeling full with the starches, the fibers help our bowel movements in case our gut feels bloated, and the sugars gives us microburst of energy for our fast-paced lives.
Fermented & Polyphenols
The last two food groups are fermented food and Polyphenols. Both of these food groups have amazing properties since we see them everywhere in the food market, hiding in plain sight. Fermented foods like yogurt and kimchi are a few examples of ways of keeping our guts happy and stopping many diseases. Polyphenols are antioxidant foods like dark chocolate, berries, dark greens, and certain fruits. These help our gut curb that sugar hunger and all in all taste really good.
All in all, our gut microbiomes are important to us and our overall health as we all try to maintain and achieve a healthy lifestyle. The phrase �we are what we eat� still implies to all of us, however, it is up to us to actually put in the work and constantly try out different foods to make sure that our gut is still functioning properly. No matter which diet you choose, pick one that will work with your body and your gut since we all are made differently. But our gut should be the first thing that we should listen to.
Cites:
Role of gut microbiota and nutrients in amyloid formation and pathogenesis of Alzheimer disease. – PubMed � NCBI:����� www.ncbi.nlm.nih.gov/pubmed/27634977
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
