Chapter 627 Three major sequelae of thalamic hemorrhage, doctor Huairen

Author: Jiangbian Yuweng

Chapter 627 Three major sequelae of thalamic hemorrhage, doctor Huairen

After seeing the brain CT film, Zhou Can's expression instantly became extremely serious.

The patient's condition is more serious than imagined.

Dark shadows can be seen in the thalamus and caudate nucleus, and even a small amount of water can be seen. This indicates that the bleeding site is in the thalamus, and the bleeding volume must be far more than 5ml.

Intracranial hemorrhage is divided into two situations. One is in the cerebral layer, such as the cerebral sulcus. Bleeding in these parts is not serious even if it exceeds 5ml. As long as the bleeding can be controlled, surgery is usually not required. The patient can absorb the bleeding on his own and then recover.

In fact, brain surgery occasionally encounters some special patients, such as malignant tumors or accidental injuries, which eventually lead to more than one-fifth of the patient's head being cut off.

But the patient eventually survived and was able to take care of himself.

Therefore, the location of cerebral hemorrhage determines whether it is high risk.

The bleeding site of the patient in front of him was in the thalamus. What worried Zhou Can most was that there was also bleeding in the brainstem.

Many people think that the thalamus is the brain stem, but it is not.

It is part of the diencephalon, divided into left and right parts, located on both sides of the third ventricle. The left and right thalamus are connected through brain gray matter masses.

In medicine, the thalamus is a sensory center, and nerve impulses from various sensory receptors throughout the body must be relayed through the thalamus before being transmitted to the cerebral cortex.

Zhou Can just checked the patient's condition and found that she was unresponsive, unconscious, and in a deep coma.

This is what worries him the most.

Hemorrhage in the thalamus can cause serious problems in the human body, but this patient was in a deep coma, and developed respiratory failure, heart failure and other symptoms, which makes people wonder whether the bleeding site is not limited to the thalamus?

Zhou Can is not very good in the field of neurosurgery, but he knows much more than the average neurosurgery doctor.

After all, I was trained by a chief physician during my surgical training, and I have personally performed many major intracranial surgeries. My knowledge and experience are all there.

After completing the regular training at Shenwai, he is often invited by Shenwai to help perform some cranial endoscopic surgeries or diagnose difficult cases.

Even Wu Baihe had discussions with him N times.

So his level of neurosurgery is not bad.

The impact of thalamic hemorrhage should be analyzed from its three major sequelae.

The first is the physical symptom. The patient will feel severe and very obvious pain in the head. Usually, few people's bodies can tolerate this kind of pain, so they will have gastrointestinal symptoms.

Such as nausea, vomiting, etc.

Others may experience hemiplegia or weakness on one side of the limb.

If limb paralysis occurs, it means that the patient's thalamic hemorrhage is very serious.

It is a bad sign, and the prognosis is often very unsatisfactory.

The second major sequelae is sensory impairment.

The thalamus is a relay station for the gray matter of the brain to receive nerve signals from the brain center and sensory organs throughout the body.

After the nerve signals from the brain center and sensory organs throughout the body are sent out, they will be 'translated' and relayed by the thalamus, and then transmitted to the cerebral cortex.

It can be seen from this that the thalamus plays an extremely important role in the processing of sensory nerve signals throughout the body.

When something goes wrong with it, it will have disastrous consequences for the nerve center and brain.

For example, a large dam is built.

If the raging torrent directly hits a large dam, it will be very easy to collapse. So smart engineers thought of designing a backwater area to buffer the huge impact of the torrent and reduce the stress on the dam.

Thereby greatly improving the safety performance of the dam.

The largest dam built by Asan was destroyed by floods on the day of completion. In addition to substandard quality caused by corruption, the failure to master some key technologies was also one of the reasons.

The thalamus functions as both a translator and a buffer station.

When problems arise, patients may experience reduced sensation or even loss of sensation. For example, the most common ones are numbness, loss of pain sensation in a certain limb, or severe loss of pain sensation.

A while ago, many patients infected with the new coronavirus suffered from loss of taste and smell, which may be caused by the impact of the thalamus.

When there is a problem with the thalamus, we may not be able to smell some pungent smells that are usually intolerable to us.

Or you can only smell it a little bit.

Of course, the sense of smell is related to the nose, as well as internal tissues and organs such as the olfactory bulb.

This requires comprehensive syndrome differentiation. If the loss of smell cannot occur, it is determined that there is a problem with the thalamus.

The third sequelae is disturbance of consciousness.

When trauma or problems occur to almost all intracranial tissues, it may cause disturbance of consciousness.

Some organizations themselves cannot cause disturbance of consciousness, but they can indirectly affect it.

For example, if a hematoma occurs, it directly squeezes the cranial cavity, or causes a sharp increase in intracranial pressure, etc.

When problems occur in the thalamus, the most common disorders of consciousness are drowsiness, wandering, confusion, lethargy, etc. In the most severe cases, coma can occur, but this is relatively rare clinically.

What is more common is a decrease in the level of consciousness, becoming dull or 'psychotic', and sometimes complete loss of consciousness may occur.

After analyzing the three major sequelae that may be caused by damage to the thalamus, the area affected by the disease can be inferred based on the patient's symptoms.

This is also the reason why Zhou Can feels that his condition is more serious than imagined.

In the first case, if the thalamus causes the patient's deep coma, it means that the patient's thalamus is extremely damaged.

In the second case, if it is not a deep coma caused by the thalamus, it is likely that there is also bleeding in the brainstem.

Either way, it's very tricky.

Doctors in several departments did not dare to accept it, probably because of the huge risks involved.

What if the patient dies after being admitted and the family members start a fight and file a lawsuit?

From birth, people know how to seek advantages and avoid disadvantages.

No matter how kind-hearted a doctor is, he will naturally not do things that are obviously not good for him.

Otherwise it would be foolish.

Zhou Can continued to study the patient's information.

The small county hospital actually performed an MRI on the patient.

You know, the price of nuclear magnetic resonance detectors is not cheap. At least they are more than 20 million, and most of them are in the 30 million range.

None of the imported instruments and equipment is cheap.

It’s very cruel for foreigners to earn such technical fees.

They make a lot of money when they sell the equipment to us, and then they have to continue to make money by maintaining and repairing the equipment.

They didn't even let us see it when it was installed.

I believe many factory owners have suffered this kind of loss when purchasing equipment imported from abroad. To buy the equipment back, they had to hire two foreign technicians. Food, accommodation, travel expenses, and wages were all covered, just like their ancestors.

The installation and debugging of the equipment, as well as problems during operation, all rely on these two foreign technicians.

This feeling of being strangled at the technical level makes countless Chinese people feel aggrieved.

But there was no way, the conditions were that at that time.

We can only learn from King Goujian of Yue, endure the hardships and endure it for now. When we develop, we can get rid of these technical bottlenecks.

The fact that a county-level hospital can have an MRI machine shows that its scale is not small.

Otherwise, even if the hospital leaders are crazy and want to purchase an inspection equipment worth tens of millions, it will be difficult for the superiors to approve it.

Zhou Can secretly thought, the doctors in the county hospital are also experts!

This shows that after consultation, the doctors at the county hospital also realized that the patient's disease may not be that simple.

It should not be a simple thalamic hemorrhage.

The accuracy of CT is very high, but the ruler is longer and the inch is shorter.

Each inspection instrument has its advantages and disadvantages.

MRI is currently recognized as the imaging examination equipment with the highest accuracy.

However, even nuclear magnetic resonance detectors have different levels.

The highest precision can already reach millimeter level.

Tuya installed one.

It's extremely difficult to make an appointment. It's okay to wait in line for a week.

Zhou Can took the patient's head MRI and looked at it carefully, and suddenly felt confident.

"Cheng Xiaolu!"

"Um!"

"Your mother's intracranial hemorrhage is not optimistic. Conservative treatment is almost hopeless. And in this case, she will definitely have to be admitted to the intensive care unit. The cost of daily treatment will be astronomical."
To be continued...