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Gao Yi Shen
Neurosurgery
About me
Graduated from Tianjin Medical University with a master's degree in Neurosurgery. Previously worked and studied at large tertiary hospitals in Beijing and Tianjin. Have a deep understanding and awareness of common and prevalent cerebral diseases, particularly skilled in understanding and formulating treatment plans for cerebrovascular diseases.
Proficient in diseases
There is a deep understanding and awareness of common and prevalent cranial diseases, especially skilled in understanding and developing treatment plans for cerebrovascular diseases.
Voices
The acute phase of brainstem hemorrhage lasts for several days.
The acute phase of brainstem hemorrhage generally lasts about two to three weeks, or 14 to 21 days, but it also needs to be specifically assessed based on the different conditions of the patient. If the hemorrhage in the brainstem is relatively severe and located in an important functional area, then the critical period may be appropriately extended. For example, if the hemorrhage is in the medulla oblongata and has already caused respiratory and circulatory failure, as well as unstable vital signs and a comatose state, then the critical period could even reach about one to two months, because it is often necessary to use a ventilator to assist breathing, and the patient's comatose state does not allow for full consciousness. However, for some brainstem hemorrhages, such as a small hemorrhage in the pons that only causes the clinical symptom of headache in the patient, the critical period is generally no more than two weeks. Thus, each patient's condition is different.
Causes of cerebral infarction
There are many causes of cerebral infarction, but the most common in clinical practice is the narrowing or occlusion of the carotid artery. Since the brain is supplied by four blood vessels, any issues with any of these vessels can potentially lead to a cerebral infarction. Conditions commonly known as the "three highs"—high blood pressure, high blood sugar, and high cholesterol—can easily lead to narrowing or even blockage of the blood vessels. Thus, these factors are fundamentally the cause. Additionally, smoking and drinking can also lead to vascular narrowing and cause cerebral infarction. In some special cases, autoimmune diseases can cause inflammation inside the vessels, leading to narrowing. Other causes include arterial tears due to trauma, which can lead to ischemia and infarction, or abnormal blood supply due to arrhythmias causing cerebral infarction.
How long does it take to wake up from a coma caused by brainstem hemorrhage?
The timing of awakening after a coma caused by a brainstem hemorrhage must be judged based on the situation. As brainstem hemorrhages are relatively severe, there is generally no possibility of awakening if the patient's breathing, heartbeat, and circulation are not stable. If the patient can breathe normally off a ventilator and has a normal heartbeat and other vital signs, and pupil responses are also normal, then typically, they may awaken within one to two weeks. However, recovery times vary from person to person depending on the specifics of the condition, the location of the hemorrhage, and the surrounding tissue involved. Therefore, assessments should be made based on specific clinical signs at the time. Particularly with hemorrhages in the medulla oblongata, once coma ensues, it's often impossible to fully awaken the patient, and many succumb to complications later on. Therefore, adequate psychological preparation is essential in clinical settings.
Trigeminal neuralgia prodrome
Trigeminal neuralgia does not have very obvious precursors. This is because trigeminal neuralgia often occurs suddenly, especially with the concept of trigger points. That is to say, once the trigger point is activated, it immediately induces pain without any warning signs. Trigger points vary from person to person, usually located primarily on the cheek. Patients who frequently suffer from trigeminal neuralgia often know these areas. Typically, the pain occurs during activities like brushing teeth with cold water or chewing hard foods such as peanuts or walnuts, triggering severe pain instantly. Thus, in the case of trigeminal neuralgia, there are no precursors, only immediate triggers and immediate pain.
What are the dangers of a concussion?
In general, as long as one follows medical advice, recovery from a concussion is usually quite satisfactory, and it rarely leaves any long-term harm. Short-term harm can result in the patient experiencing some very painful symptoms such as headaches, dizziness, nausea, vomiting, etc. Such subjective experiences can comparatively make the patient suffer. For those who are emotionally excited or fragile, it may even lead to anxiety and depression, which are some of the recent damages. In the long term, some patients might experience a loss of memory, particularly short-term memory, which can also cause some inconvenience in their lives. However, overall, the damage from a concussion is very minimal, and as long as it is treated properly, there is generally no harm in the later stages.
Methods of Cerebral Infarction
There are many methods for treating cerebral infarction, but it is essential to make judgments based on the situation, as each patient's condition is different and requires different treatment approaches. For patients with acute cerebral infarction, treatments such as emergency thrombolysis or thrombectomy can be undertaken. For chronic cerebral infarction, initially, medical treatment is applied, including managing blood pressure, lowering blood lipids, stabilizing blood sugar levels, quitting smoking and alcohol, etc. Subsequently, this includes the oral administration of antiplatelet aggregation medications, which can effectively reduce the recurrence of cerebral infarction. Finally, corresponding surgical treatments are considered, including endarterectomy, superficial temporal artery to middle cerebral artery anastomosis, and appropriate stent implantation surgeries, depending on the specific characteristics. (Specific medications should be administered under the guidance of a physician.)
What should be paid attention to in the diet for cerebral infarction?
There are many dietary considerations for patients with cerebral infarction: The first point is to definitely eliminate some unhealthy eating habits, including smoking, drinking alcohol, consuming large amounts of meat, binge eating, sitting for long periods, and not exercising, among other things. Improving these bad habits can greatly help in reducing the recurrence of cerebral infarction. The second point is to adopt a diet low in salt and fat and high in protein. It is essential to avoid greasy and pickled foods on a regular basis to also reduce the recurrence of cerebral infarction. The third point is to eat more green leafy vegetables on a daily basis, especially those that are local and seasonal. If blood sugar levels are stable, increasing the consumption of fruits can also enhance the body's resistance and reduce the recurrence of cerebral infarction.
Can a cerebral infarction be treated?
Stroke is treatable, but it must also be judged based on the situation. The meaning of "treatable" here is that various treatment plans can be used to reduce the further occurrence of cerebral infarction and the situation of recurrence. However, the nerve cells that have already suffered ischemic necrosis cannot be restored to exactly the same condition as before. This means that the best scenario is recovery to the point of being able to take care of oneself, but it is absolutely impossible to return to the state of freedom before the illness, such as running and jumping. Currently, there are many treatment methods, including medication and surgical treatment. Each of these is a mode of treatment, and each case's differences determine different treatment plans. Decisions must be made according to the situation.
Trigeminal neuralgia should register for which department?
The department for registering trigeminal neuralgia depends on the distribution of departments in the local hospital. Most commonly, registration is done in the department of functional neurosurgery. However, different hospitals may have different levels of specialization and may employ varying treatment methods which require different departments. For instance, initially, one can register at the department of neurosurgery for oral medication adjustment, usually with carbamazepine. If there is no significant improvement later on, one may register with the department of pain management or anesthesiology for nerve block treatment. Due to the detailed specialization in some hospitals, it might also be necessary to consult other departments. If there is still no effective outcome, it is necessary to register at the department of neurosurgery for surgical treatment to fundamentally address the disease.
What department does pheochromocytoma see?
Pheochromocytomas generally require a visit to urology for treatment. Initially, they mostly present with symptoms of hypertension, leading many to first visit cardiology. After differential diagnoses have ruled out other causes and confirmed pheochromocytoma, patients must then seek treatment from urology. Pheochromocytomas are generally located in the adrenal glands, hence they require surgical removal by a urologist. It is crucial to strictly control blood pressure during surgery, as fluctuations can be severe and significantly impact the patient's physical and mental health. Therefore, if a pheochromocytoma is detected, it is critical to seek timely medical treatment for a relatively better prognosis.