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Chen Yu Fei
Neurosurgery
About me
With 11 years of experience in the medical field, I am dedicated to the field of surgery, working to relieve patients' suffering.
Proficient in diseases
Specializes in the treatment of cranial injuries, hypertensive intracerebral hemorrhage, various cranial tumors, and the diagnosis and treatment of cerebrovascular diseases.
Voices
What to do if there is fever due to brainstem hemorrhage?
When a patient exhibits brainstem hemorrhage accompanied by fever, it is crucial to promptly monitor their body temperature and assess the extent of the temperature increase. If the temperature rises above 38.5 degrees Celsius, it is recommended to treat the patient with antipyretic medications. Clinically, it is generally recommended to use Nimodipine dispersible tablets or administer Amobarbital via muscular injection for treatment. Additionally, it is essential to employ physical methods of cooling at areas of arterial blood vessel concentration on the patient's body surface, such as considering the use of alcohol or warm water baths, or placing ice packs on major arterial sites to effectively achieve physical cooling. (Please use the above medications under the guidance of a doctor, and do not self-medicate blindly.)
Symptoms of Pituitary Tumors
For patients with pituitary tumors, they often present with headaches, typically located behind the eye sockets, forehead, and both temporal areas. In the early stages of the disease, the nature of the headache is relatively mild and intermittent, mostly due to direct stimulation by the tumor or due to increased intrasellar pressure causing compression of the pituitary dural sac and the diaphragm sellae. When the tumor breaks through the diaphragm sellae, the intrasellar pressure gradually decreases, and the pain may gradually lessen or disappear. In the later stages of the disease, headaches may occur due to the tumor spreading to the parasellar region, invading the dura and vessels at the skull base, and compressing the trigeminal nerve, causing severe pain. In rare cases, due to a large pituitary adenoma growing upward into the third ventricle, breaking through and causing obstruction of the foramen of Monroe or the cerebral aqueduct, progressive intracranial pressure increases.
Hydrocephalus MRI manifestations
For patients with hydrocephalus, an examination using cranial MRI often shows significant dilation of the ventricular system, especially in patients with communicating hydrocephalus, where the entire ventricular system can appear significantly dilated. Once such a condition is discovered, it is advisable to promptly visit a local hospital and consult a neurosurgeon to help assess the current situation, mainly to determine the primary cause of the hydrocephalus, as targeted treatment can only be conducted once the cause is identified. For severe cases of hydrocephalus, surgery is generally recommended, and clinically, a ventriculoperitoneal shunt procedure is commonly chosen.
Trigeminal neuralgia acupuncture points
For patients with trigeminal neuralgia, using acupuncture as a treatment method can play a certain auxiliary role, helping to alleviate pain and improve symptoms. It is generally recommended to choose acupuncture in the area where the trigeminal nerve root is distributed, which helps in providing auxiliary therapeutic effects. In addition to this, some other physical methods also have very good helpful effects, such as massage, manipulation, physiotherapy, acupuncture, and electrotherapy. However, to achieve a complete cure, it is still recommended to use surgical methods for treatment. By implementing microvascular decompression surgery, a good therapeutic effect can often be achieved, with the patient's original symptoms and signs gradually improving and even disappearing, and some patients do not relapse.
Neuroblastoma ultrasound manifestations
Regarding the ultrasonic manifestations of neuroblastoma, they typically occur at the site of the neuroblastoma. Some neuroblastomas occur in the retroperitoneal space, such as near the adrenal glands or alongside the spine, usually presenting direct and indirect signs. Direct signs often manifest as a large tumor volume, often crossing the midline, characterized internally primarily by hypoechoic areas with significant returns unevenness, and rich blood flow around the tumor. Some patients may exhibit tumor calcification, which can cause encasement or invasion of major retroperitoneal vessels, but less commonly invasion resulting in acid efflux. Indirect signs mainly include causing renal hydronephrosis, potentially leading to enlargement of surrounding lymph nodes, and causing ascites.
Precursors of brainstem hemorrhage
For patients with brainstem hemorrhage, there is often a lack of specific precursors, and most patients do not have obvious characteristic symptoms beforehand. Some patients may have underlying chronic diseases such as hypertension, diabetes, and hyperlipidemia. Prior to a brainstem hemorrhage, patients often exhibit mild headaches, dizziness, nausea, and significant increases in blood pressure. Certain triggers like fatigue, exhaustion, emotional stress, or vigorous activity can lead to a brainstem hemorrhage. Once a hemorrhage occurs, patients typically experience severe headaches, dizziness, nausea, vomiting, and even coughing or choking when drinking water. In more severe cases, patients may also show signs of drowsiness, stupor, or even coma.
Causes of brainstem hemorrhage
There are many reasons that cause brainstem hemorrhage. Clinically, it is mostly seen in patients with underlying diseases, such as hypertension, diabetes, and hyperlipidemia. Due to the lack of effective control and treatment of blood pressure, blood sugar, and blood lipids over a long period, severe arteriosclerotic changes and even arteriosclerotic plaques can develop. The blood vessels’ own regulatory functions gradually deteriorate. Under certain triggering factors, such as fatigue, exhaustion, and mental stress, blood pressure can transiently increase. When it exceeds the blood vessels' capacity to adjust, brainstem hemorrhage is likely to occur. Once brainstem hemorrhage occurs, the condition is often critical and requires immediate transportation of the patient to the nearest hospital for treatment.
Neuroblastoma is divided into several types.
Neuroblastoma can be classified into several types, such as abdominal neuroblastoma, which often presents with obvious abdominal distention. Patients may experience difficulty defecating, dry stools, and stubborn constipation. Thoracic neuroblastoma mainly presents with obvious difficulty in breathing, accompanied by shortness of breath, frequent breathing, and low blood oxygen saturation. Spinal neuroblastoma primarily causes a noticeable decrease in trunk and limb strength, with most patients experiencing significant limb motor dysfunction and difficulty walking.
Signs before death from brainstem hemorrhage
For patients with brainstem hemorrhage, if the patient's life is in danger, they often exhibit some special clinical manifestations. For example, the patient may present with apparent consciousness disturbances, characterized by moderate to severe coma states. In this state, the patient is unaware, unable to open their eyes or speak. When subjected to strong painful stimuli on their limbs, there is often no significant response, or it may just cause muscle twitching. Additionally, patients with brainstem hemorrhage may exhibit severe disturbances in vital signs as they approach death, characterized by shallow, rapid, and weakening spontaneous breathing, sometimes even ceasing, often requiring ventilator support. Also, difficulty in maintaining blood pressure may lead to a sudden drop in pressure or even shock.
post-concussion syndrome
For patients with concussions, especially those with mild concussions, they generally do not retain obvious sequelae. Most patients gradually alleviate or even eliminate the original symptoms after resting. However, some patients with more severe concussions still experience repeated headaches, dizziness, nausea, vomiting, and other discomfort during the recovery period. At this time, it is appropriate to treat patients by using some brain-enhancing and nerve-nourishing medications. Meanwhile, patients should be encouraged to actively participate in social activities and do some simple physical exercises, which can help stabilize and recover from the condition. Additionally, it is also suggested that concussion patients receive appropriate psychological counseling. (Specific medications should be taken under the guidance of a physician.)