Chapter 2828： 【2828】Conservative means

Chapter 2828 [2828] Conservative means

The place where cerebrospinal fluid is produced is the lateral ventricle. In addition to the lateral ventricle, there is a third ventricle and a fourth ventricle.

The ventricle system can be called the "pool" that holds the cerebrospinal fluid, which flows from the lateral ventricle to the third ventricle to the fourth ventricle.

How cerebrospinal fluid is recovered is through arachnoid granules and then recovered to the venous system.

The above loop through sounds like a very closed environment.

Exactly. The blood-brain barrier that we can often hear, to be precise, includes three barriers: blood-brain, blood-cerebrospinal fluid, and cerebrospinal fluid-brain barrier. It is evident that the cerebrospinal fluid environment is so closed.

The specific deconstruction of how "closedness" and "barrier" came from is more complicated. There are interpretations at the cellular level and mechanical physics.

Back to the current patient, hydrocephalus, hydrocephalus is the area of ​​"water" in the brain, and there is a lot of cerebrospinal fluid. There is too much cerebrospinal fluid, which means that the "water" may be secreted too much, there may be a problem with the recovery mechanism, or the flow path may be blocked on the way, and the "water" body will not circulate smoothly. As a result, the "pool" containing the cerebrospinal fluid will naturally expand.

The clinical manifestations are that CT shows dilation of the ventricular system and/or subarachnoid space, and compression of normal brain tissue is often accompanied by brain atrophy. What is brain atrophy? I just mentioned the disease of cerebellar atrophy, which is only more serious than cerebellar atrophy.

Typical symptoms: adult patients with headache, nausea and vomiting, abnormal drowsiness and mania, ataxia and **** incontinence, etc.

In view of the fact that we have talked about a lot of cerebrospinal fluid problems above, we can know that if hydrocephalus is caused by other diseases, such as tumors, it may be solved with a surgical knife.

Unfortunately, clinically more common hydrocephalus patients may not have a clear and visible cause. If more complex secretion problems are involved, internal medicine is naturally better than surgery.

Surgery does not cure the root cause, and it is feared that there will be frequent recurrences, so why let the patient suffer a stab in vain.

Must use surgical means, and it is necessary to clarify the cause that can be solved by surgery.

For example, ventriculoscopic third ventriculostomy is aimed at the obstruction of cerebrospinal fluid circulation in the third ventricle through the midbrain aqueduct to the fourth ventricle. A hole is made directly in the third ventricle to direct the cerebrospinal fluid to the prepontine cistern.

If the cause cannot be identified or the cause cannot be solved by surgical means, surgery also has a conservative surgical treatment plan, which is the most commonly referred to as cerebrospinal fluid shunt.

The time is tight, and a group of neurosurgeons entered the ward first to make rounds.

Dr. Kim was waiting outside, waiting for them to check their room before going in.

Starting from the bottom of the bed, we found a friend of Dr. Kim, a patient in twenty-three beds. The patient was a woman in her thirties and forties. The preliminary judgment may be hydrocephalus caused by some kind of infection, because no other incentives can be found for the time being. However, after the diagnosis of cerebral arteriovenous malformation was later found, it was difficult to say which of the two came first.

The patient's current condition is relatively serious, and he has already experienced drowsiness.

Here comes the group of junior brothers and sisters.

During the ward rounds, Huang Zhilei asked his juniors and brothers to go up to perform neurosurgical examinations on the patients, which was regarded as an on-site examination.

A patient with hydrocephalus, according to what Pan and several of his classmates thought, just by looking at the patient's head, he could not tell what the condition of hydrocephalus was.

If you want to thoroughly check ataxia, the patient is lethargic, asks the patient to open their eyes to answer questions, etc. The patient cannot cooperate with the doctor.