Trigeminal Neuralgia

Trigeminal neuralgia (TN) is a type of chronic pain that affects your face. It causes extreme, sudden burning or shock-like pain. It usually affects one side of the face. Any vibration on your face, even from talking, can set it off. The condition may come and go, disappearing for days or even months. But the longer you have it, the less often it goes away.

TN usually affects people over 50, especially women. The cause is probably a blood vessel pressing on the trigeminal nerve, one of the largest nerves in the head. Tumors and multiple sclerosis can also cause TN, but in some cases the cause is unknown.

There is no specific test for TN. It can be hard to diagnose, since many other conditions can cause facial pain. Treatment options include medicines, surgery, and complementary techniques.

NIH: National Institute of Neurological Disorders and Stroke

Vascular Diseases

What are vascular diseases?

Your vascular system is your body's network of blood vessels. It includes your:

• Arteries, which carry oxygen-rich blood from your heart to your tissues and organs
• Veins, which carry the blood and waste products back to your heart
• Capillaries, which are tiny blood vessels that connect your small arteries to your small veins. The walls of the capillaries are thin and leaky, to allow for an exchange of materials between your tissues and blood.

Vascular diseases are conditions which affect your vascular system. They are common and can be serious. Some types include:

• Aneurysm - a bulge or "ballooning" in the wall of an artery
• Atherosclerosis - a disease in which plaque builds up inside your arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.
• Blood clots, including deep vein thrombosis and pulmonary embolism
• Coronary artery disease and carotid artery disease, diseases that involve the narrowing or blockage of an artery. The cause is usually a buildup of plaque.
• Raynaud phenomenon - a disorder that causes the blood vessels to narrow when you are cold or feeling stressed
• Stroke - a serious condition that happens when blood flow to your brain stops.
• Varicose veins - swollen, twisted veins that you can see just under the skin
• Vasculitis - inflammation of the blood vessels

What causes vascular diseases?

The causes of vascular diseases depend on the specific disease. These causes include:

• Genetics
• Heart diseases such as high cholesterol and high blood pressure
• Infection
• Injury
• Medicines, including hormones

Sometimes the cause is unknown.

Who is at risk for vascular diseases?

The risk factors for vascular diseases can vary, depending on the specific disease. But some of the more common risk factors include:

• Age - your risk of some diseases goes up as you get older
• Conditions that can affect the heart and blood vessels, such as diabetes or high cholesterol
• Family history of vascular or heart diseases
• Infection or injury that damages your veins
• Lack of exercise
• Obesity
• Pregnancy
• Sitting or standing still for long periods of time
• Smoking

What are the symptoms of vascular diseases?

The symptoms for each disease are different.

How are vascular diseases diagnosed?

To make a diagnosis, your health care provider will do a physical exam and ask about your symptoms and medical history. You may have imaging tests and/or blood tests.

How are vascular diseases treated?

Which treatment you get depends on which vascular disease you have and how severe it is. Types of treatments for vascular diseases include:

• Lifestyle changes, such as eating a heart-healthy diet and getting more exercise
• Medicines, such as blood pressure medicines, blood thinners, cholesterol medicines, and clot-dissolving drugs. In some cases, providers use a catheter to send medicine directly to a blood vessel.
• Non-surgical procedures, such as angioplasty, stenting, and vein ablation
• Surgery

Can vascular diseases be prevented?

There are steps you can take to help prevent vascular diseases:

• Make healthy lifestyle changes, such as eating a heart-healthy diet and getting more exercise
• Don't smoke. If you are already a smoker, talk to your health care provider for help in finding the best way for you to quit.
• Keep your blood pressure and cholesterol in check
• If you have diabetes, control your blood sugar
• Try not to sit or stand for up long periods of time. If you do need to sit all day, get up and move around every hour or so. If you are traveling on a long trip, you can also wear compression stockings and regularly stretch your legs.

Vasculitis

Vasculitis is an inflammation of the blood vessels. It happens when the body's immune system attacks the blood vessel by mistake. It can happen because of an infection, a medicine, or another disease. The cause is often unknown.

Vasculitis can affect arteries, veins and capillaries. Arteries are vessels that carry blood from the heart to the body's organs. Veins are the vessels that carry blood back to the heart. Capillaries are tiny blood vessels that connect the small arteries and veins.

When a blood vessel becomes inflamed, it can:

• Narrow, making it more difficult for blood to get through.
• Close off completely so that blood can't get through.
• Stretch and weaken so much that it bulges. The bulge is called an aneurysm. If it bursts, it can cause dangerous bleeding inside the body.

Symptoms of vasculitis can vary, but usually include fever, swelling and a general sense of feeling ill. The main goal of treatment is to stop the inflammation. Steroids and other medicines to stop inflammation are often helpful.

NIH: National Heart, Lung, and Blood Institute

VLDL Cholesterol

What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.

What is VLDL cholesterol?

VLDL stands for very-low-density lipoprotein. Your liver makes VLDL and releases it into your bloodstream. The VLDL particles mainly carry triglycerides, another type of fat, to your tissues. VLDL is similar to LDL cholesterol, but LDL mainly carries cholesterol to your tissues instead of triglycerides.

VLDL and LDL are sometimes called "bad" cholesterols because they can contribute to the buildup of plaque in your arteries. This buildup is called atherosclerosis. The plaque that builds up is a sticky substance made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, the plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your body. It can lead to coronary artery disease and other heart diseases.

How do I know what my VLDL level is?

There isn't a way to directly measure your VLDL level. Instead, you will most likely get a blood test to measure your triglyceride level. The lab can use your triglyceride level to estimate what your VLDL level is. Your VLDL is about one-fifth of your triglyceride level. However, estimating your VLDL this way does not work if your triglyceride level is very high.

What should my VLDL level be?

Your VLDL level should be less than 30 mg/dL (milligrams per deciliter). Anything higher than that puts you at risk of heart disease and stroke.

How can I lower my VLDL level?

Because VLDL and triglycerides are linked, you can lower your VLDL level by lowering your triglyceride level. You may be able to lower your triglycerides with a combination of losing weight, changing your diet, and getting exercise. It is important to switch to healthy fats and cut back on sugar and alcohol. Some people may also need to take medicines.

Von Hippel-Lindau Disease

What is Von Hippel-Lindau disease (VHL)?

Von Hippel-Lindau disease (VHL) is a rare disease that causes tumors and cysts to grow in your body. They can grow in your brain and spinal cord, kidneys, pancreas, adrenal glands, and reproductive tract. The tumors are usually benign (non-cancerous). But some tumors, such as those in the kidney and pancreas, can become cancerous.

What causes Von Hippel-Lindau disease (VHL)?

VHL is a genetic disease. It is inherited, which means that it is passed down from parent to child.

What are the symptoms of Von Hippel-Lindau disease (VHL)?

Symptoms of VHL depend on the size and location of the tumors. They may include:

• Headaches
• Problems with balance and walking
• Dizziness
• Weakness of the limbs
• Vision problems
• High blood pressure

How is Von Hippel-Lindau disease (VHL) diagnosed?

Detecting and treating VHL early is important. Your health care provider may suspect that you have VHL if you have certain patterns of cysts and tumors. There is a genetic test for VHL. If you have it, you will need other tests, including imaging tests, to look for tumors and cysts.

What are the treatments for Von Hippel-Lindau disease (VHL)?

Treatment can vary, depending on the location and size of the tumors and cysts. It usually involves surgery. Certain tumors may be treated with radiation therapy. The goal is to treat growths while they are small and before they do permanent damage. You will need to have careful monitoring by a doctor and/or medical team familiar with the disorder.

NIH: National Institute of Neurological Disorders and Stroke