Just finished a week at my internship shadowing Dr. Sixto Bogantes, a neurologist, at Hospital Nacional de Niños 🏥. I got to see a range of patients and procedures. One interesting application of ultrasound I learned about is called the transcranial doppler sonogram 🧠. This is an ultrasound performed on the cranium to determine blood flow velocity in arteries of the brain 🩸. Tracking blood flow velocity is especially important for patients with sickle cell disease as they are prone to stroke. High blood flow velocities can indicate the need for intervention to prevent stroke. I took a picture of the specific ultrasound machine used so I could learn more. Check it out !
Transcranial Doppler Machine
I also observed several types of epilepsies. One specific type of epilepsy I will talk about is West syndrome. West syndrome is characterized by seizures during infancy in which the child’s body suddenly bends forward and their arms and legs stiffen. These types of seizures can be controlled by medications, surgery (if caused by a brain lesion), or starting a ketogenic diet 🥑🍗.
Today, I had the opportunity to follow Dr. Bogantes at Hospital San Juan de Dios. This is not a pediatric hospital, so I was able to see adult patients. One patient in the neurology department was recovering from a stroke. He had undergone thrombolysis, a procedure used to break up clots and regained some function on the right side of his body after this procedure. Dr. Bogantes showed me the CT scan of this patient showing where his artery had been occluded. He mentioned that MRI is a better tool for viewing this condition but also said that not all countries use MRI to assess the brain condition for acute ischemic stroke. I thought it was interesting to learn about the differences in how different countries utilize imaging to treat patients.
Another note: while at San Juan de Dios I visited the emergency room. Dr. Bogantes had told me that San Juan de Dios would be more chaotic than Niños, however, the ER was still shocking to me. It was very crowded. Beds with patients in them lined both sides of the hallway, leaving a narrow space to walk through. However, I followed Dr. Bogantes through the narrow space to get to the patient he needed to see and ended up learning something very interesting! Dr. Bogantes pointed out that patients’ eyes point towards the sight of brain injury. This patients’ eyes pointed to the left ⬅️, indicating that he was injured on the left side of his brain. This made sense when I figured out that the right side of his body had lost function.
Lastly, I checked out a few cool libraries 📚 at the University of Costa Rica to get my work done. My favorite was Luis Demetrio Tinoco Library.
Luis Demetrio Tinoco Library
P.S. here’s a peacock I saw in Escazu, CR 🦚.
Peacock ‼️