Chapter 220 Dangerous brain herniation, use blood to detect bleeding points

Author: Jiangbian Yuweng

Chapter 220 Dangerous brain herniation, use blood to detect bleeding points

Not long after, he rushed to the emergency room of the neurosurgery department.

I saw a dozen doctors and nurses surrounding a bed in the emergency room.

There was also a blond man who seemed to be a family member standing next to the hospital bed and looking worriedly.

"It turns out they are foreign friends. No wonder the Department of Neurology attaches so much importance to it."

It must be explained that this is not about worshiping foreigners.

Let foreign friends feel the beauty of China as much as possible, which can attract more foreign friends to invest or work. This is a kind of far-sightedness.

In the past, when Zhou Can saw foreign friends receiving preferential treatment in China, he always felt it was too much.

I felt very contemptuous of this in my heart.

Later, as his knowledge increased, his thinking gradually became broader, and he gradually understood the far-reaching purpose of treating foreign friends preferentially.

Treating foreign friends well can gain their friendship and recognition. They will also be more willing to work and invest in such a kind, peaceful and welcoming country, which can drive economic, technological and other development.

"Dr. Zhou is here!"

This nurse girl should be the one who called Zhou Can just now.

Zhou Can has some impression of her, her name is Shu Qian.

"Director Wen, Director Wu..."

Zhou Can walked over and greeted these big shots.

Four chief physicians came to treat the patient, and there were seven or eight residents. The hospital paid great attention to this patient.

Otherwise it would be impossible to mobilize so many medical resources.

"Dr. Zhou, can you take a look at the films and medical records first? The patient had cerebral hemorrhage and was just sent here. A head CT was taken."

After Wu Baihe said a few words to Zhou Can, he leaned over again to carefully check the patient's condition.

Zhou Can took the CT film and looked at it, and saw multiple white spots on it, including a huge white spot at one location.

White spots on brain CT are commonly caused by brain calcification, hemorrhage or tumors.

The patient was in a severe coma at the moment and had no response to calling or tapping on the shoulder.

When I opened my eyelids, my eyes were dull and blurry.

It shows that her condition is very critical.

Those small white spots should just be calcification of the pineal gland or choroid plexus. This physiological calcification will not have much impact on the patient and does not require treatment.

The key lesion should be the huge white spot.

White spots on brain CT usually refer to high-density lesions. The specific cause of the formation should be comprehensively judged based on the size, location, CT value, mass effect of the lesion and the degree of compression of the surrounding brain tissue.

Zhou Can has been training at Shenwai for several months and has long since learned to read brain CT, color ultrasound, X-ray and other films.

The cause of this patient's disease is actually easy to diagnose.

The intracranial pressure is very high, and the brain tissue is squeezed and displaced, resulting in cerebral herniation with extremely high mortality and disability rates.

At present, the bleeding site can be roughly locked under the falx cerebri.

When the brain herniation formed in this area exceeds a certain level, it is far more dangerous than ordinary brain herniation. For example, foramen magnum herniation usually mainly causes respiratory failure or respiratory arrest. Before the onset, there will be stiffness of the neck and sudden pupils.

Symptoms such as large and small, brainstem hypoxia and other symptoms.

In general, the onset of foramen magnum hernia is gradual, leaving doctors time for rescue.

The patient is probably suffering from a subfalx hernia, which has a very high fatality and disability rate. A large amount of nerve tissue will be displaced or cut, and most of the nerves will be necrotic, leaving doctors with a very short rescue time.

.

Many patients die before their skulls are drilled.

"Xiao Zhou, what do you think of the patient's condition after seeing it?"

Lord Wen probably just wanted to test Zhou Can.

There were several chief doctors on site, and it would be easy to diagnose the cause.

It is not a particularly rare disease in itself.

"It should be subfalx cerebri hernia accompanied by intracranial hemorrhage and intracranial hypertension. The patient's condition is extremely dangerous. When the subfalx cerebri hernia is mild, it will only cause paralysis of the contralateral lower limb and difficulty urinating. This patient is already in a deep coma.

It shows that the brain tissue displacement caused by cerebral herniation has been extremely serious. The best way is to perform craniotomy immediately. Judging from her current situation, traditional craniotomy may not be enough. Immediate burr hole endoscopic surgery may have a chance of survival."

In this situation, Zhou Can would naturally not play any tricks to hide his clumsiness.

Instead, state all your diagnostic opinions truthfully.

As for whether the chief physicians will adopt it or not, that depends on what they want.

"It seems that inviting Dr. Zhou to participate in the rescue is a very correct decision! Your diagnosis is basically consistent with ours."

If you listen carefully, you will find that Wu Baihe asked Zhou Can to come over, not Zhou Can to come over and participate in the rescue.

For the director of the Department of Neurology to be so polite is enough to illustrate Zhou Can's status in the minds of these chief doctors.

"Immediately issue a critical illness notice! Then talk to the family members. If they agree, immediately ask the family members to sign the surgery notice, and then send them to the operating room for emergency surgery."

Wu Baihe made a prompt decision and made a series of arrangements.

Any kind of brain herniation is extremely dangerous. In this case, most of the patient's body was already in limbo, and emergency surgery was the only chance of survival.

"But the site of intracranial bleeding has not yet been identified, so a hasty operation is full of too many uncertainties. This operation is inherently risky, and I'm worried..."

A chief physician questioned with a worried look on his face.

"The patient's current condition simply cannot wait for angiography. I have performed intracranial surgeries for so many years and already know the structure of the brain very well. I can only rely on experience. Let's take action!"

The Peak Scalpel is not called for nothing, Wu Baihe probably knows more about the structure of the brain than anyone else.

Even without taking pictures, he was confident that he could successfully complete this high-risk operation with the help of his rich surgical experience.

After Wu Baihe gave the order, he personally talked to the foreign friend.

I really didn't realize that Wu Baihe not only has the reputation of being the best scalpel, but he also speaks English very fluently.

Communication with family members went very smoothly.

I quickly agreed to the surgery.

The nurse immediately brought clippers to shave the patient's hair and prepare the patient's skin before surgery.

The patient was quickly rushed to the operating room.

Dr. Feng, the most powerful anesthesiologist in Tuya Hospital, was also temporarily called in to work overtime.

Zhou Can helped administer anesthesia to the patient.

Different from the anesthesia of ordinary patients, this patient's anesthesia surgery has many skills and key points, and the general anesthesia surgery is required to be completed in the shortest time.

Dr. Feng and he worked at full capacity, and the two of them cooperated with each other in a tacit understanding. After a lot of hard work, they were finally able to successfully give the patient general anesthesia.

[Anesthesia experience value +1.]

[The first time you complete general anesthesia for a brain herniation patient, you will be rewarded with anesthesia experience value +100.]

This is the first time Zhou Can has received an experience point reward for anesthesia, and it is as high as 100 points.

This made him extremely surprised.

However, the implementation of this anesthesia operation was indeed full of challenges, and he also learned many advanced skills.

Especially the protection and stabilization of patients' vital signs during emergencies, including preoperative medication, are often learned for the first time.

"Dr. Zhou's surgery is fast, and you incise the scalp layer."

Wu Baihe didn't invite Zhou Can to come over and watch the fun.

In addition to Zhou Can's endoscopic surgery ability, he can serve as a backup surgeon when necessary. There is also Zhou Can's rapid surgical ability, which cannot be compared with other doctors.

There are only two high-speed surgeons in the entire Tuya Hospital.

That is Dr. Xu and Zhou Can.

Dr. Xu would not be asked to participate in such a rescue operation unless it was absolutely necessary.

Although a long time has passed since that incident, Dr. Xu's identity is still highly sensitive.

This operation also involves foreign friends, so the hospital is extremely cautious.

If the patient is not rescued and the list of surgeons is posted, and someone sees Dr. Xu appearing on the list, the trouble will be big.

Zhou Can's sharp knife has been passed down by Dr. Xu. Although it is still far from the best, it can be used.

Zhou Can stood at the main knife position and lived up to his high expectations, cutting the scalp layer as quickly as possible according to the drawn knife position.

Zhou Can did not dare to do the next cranial drilling.

Because the drill is not drilled well, it can easily cause serious damage to the patient.

Drilling holes in the removed bone flap is something that even a surgeon would dare to do. However, drilling holes directly into the patient's skull is extremely technical, and even an average deputy chief physician would find it difficult to complete this operation.

Under the skull is the dura mater, and below that are important brain tissues, brainstem, blood vessels, and nerves.

No matter where it is injured, it will cause unpredictable damage.

It directly causes the patient to have respiratory arrest and cardiac arrest, which is a completely normal thing.

Therefore, skull drilling must be completed by a chief neurosurgeon with extremely rich surgical experience.
To be continued...