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Jiang Fang Shuai
Neurosurgery
About me
Loudi Central Hospital, Department of Neurosurgery, attending physician, has been engaged in clinical work in the field of neurosurgery for many years, with rich clinical experience in the diagnosis and treatment of neurosurgical diseases.
Proficient in diseases
Specializes in acute epidural hematoma, subdural hematoma, intracerebral hematoma, traumatic subarachnoid hemorrhage. Cerebrovascular diseases mainly include cerebral infarction, cerebral hemorrhage, cerebral aneurysm and other common diseases.
Voices
Gliomas grow where?
Glioma is a stubborn malignant tumor of the central nervous system that originates from neuroglial cells. Therefore, gliomas can occur anywhere there are neuroglial cells. Clinically, based on the common sites of the tumors, gliomas can be divided into supratentorial gliomas, which are mostly found in the cerebral hemispheres, frontal lobes, temporal lobes, and parietal lobes, and are less common in the occipital lobes. There are also infratentorial gliomas primarily in the cerebellum. Additionally, a few gliomas are found in the brainstem and spinal cord.
Causes of Hydrocephalus
Under normal conditions, the secretion, circulation, and absorption of cerebrospinal fluid (CSF) maintain a dynamic balance. In some pathological states, this balance is disrupted, leading to an excessive accumulation of CSF within the ventricular system, a condition known as hydrocephalus. Hydrocephalus can be classified into obstructive hydrocephalus and communicating hydrocephalus. The causes of obstructive hydrocephalus mainly include obstructions in the ventricular system, such as congenital malformations or abnormal development of the cerebral aqueduct, which are the most common causes of hydrocephalus in infants. In adults, tumors, bleeding, blockages, or compression of the ventricular system are also common causes of hydrocephalus. Communicating hydrocephalus results primarily from acquired diseases, such as cranial infections or blockages of arachnoid granulations by subarachnoid hemorrhage, leading to impairments in CSF absorption.
How to administer first aid for a concussion
After a concussion occurs, the injured should be quickly moved from a dangerous environment to a safe area. The injured person should lie flat and rest quietly without sitting up or standing. The head can be appropriately cooled, and it is important to keep the body warm. For patients who are unconscious, it is necessary to keep the airway clear and closely observe their consciousness and pupils. If there are airway secretions or vomiting, they should be cleaned up promptly. If the patient has already experienced respiratory or circulatory problems, immediate cardiopulmonary resuscitation should be performed. After the aforementioned emergency treatment, the next step is to transport the patient to a nearby well-equipped hospital for further diagnosis and treatment.
How long is the period of brainstem hemorrhagic edema?
Brainstem hemorrhage, like hemorrhages in other parts of the brain, also has a period of cerebral edema. Cerebral edema is primarily caused by direct injury to brain tissue following hemorrhage, local ischemic and hypoxic changes, local metabolic products, and some damage to the vascular endothelium. Generally, the edema becomes apparent three days after the hemorrhage, peaks between three to seven days, begins to subside after ten days, and completely resolves around fourteen to fifteen days. However, there are exceptions, such as cases where edema occurs shortly after injury or within a few hours, and the peak period of edema lasts for several weeks, or even up to a month without complete resolution.
Trigeminal neuralgia pain level
The World Health Organization classifies pain into five levels. Level zero is no pain. Level one is mild pain that does not require medication. Level two is moderate pain that requires medication. Level three is severe pain that necessitates medication. Level four involves severe and intense pain, often accompanied by changes in vital signs such as blood pressure, pulse, and respiration. Trigeminal neuralgia is a type of severe pain that occurs repeatedly in the trigeminal nerve area. It is recognized globally as one of the most painful diseases, often referred to as the "world's greatest pain" and "the cancer that does not kill." Patients often live in a state of feeling better off dead, which indicates the extreme level of pain associated with this disease. The pain level for this condition is classified as level four, the highest level.
Mild concussion sequelae
Mild concussions generally do not have any lasting effects. After a mild concussion, as long as one rests well, maintains a good mindset, and uses medication when necessary, along with symptomatic supportive treatment, the vast majority of people can fully recover within one to two weeks without any lasting effects. Only a few people, due to psychological and mental factors, may continue to experience symptoms that are difficult to improve for more than three months. In these cases, we consider these to be the after-effects of mild concussion, which mainly manifest as headaches, dizziness, dry heaving, vomiting, anxiety, insomnia, lack of concentration, memory decline, slow reactions, irritability, and a bad temper, among others.
Causes of cerebral hemorrhage
Any cause of cerebral vascular rupture and bleeding is called cerebral hemorrhage, including traumatic cerebral hemorrhage and non-traumatic cerebral hemorrhage. Traumatic cerebral hemorrhage, as the name suggests, is caused by head trauma, while the most common cause of non-traumatic cerebral hemorrhage is hypertension. Under the long-term impact of high blood pressure and high blood flow, numerous microaneurysms form in the brain's blood vessels. When blood pressure suddenly increases under certain conditions, these microaneurysms may rupture and bleed. The second most common cause is cerebral amyloid angiopathy, where blood vessels become aged, brittle, and weak, leading to rupture and bleeding. The third most common cause includes intracranial aneurysms and vascular malformations, which also partly cause hemorrhage. The fourth most common cause involves intracranial tumors, meningiomas, melanomas, and others. The fifth most common cause is related to hematological disorders, such as leukemia and deficiencies in clotting factors. Lastly, another cause is the prolonged use of anticoagulant and antiplatelet medications, which also contribute to cerebral hemorrhage.
Is trigeminal neuralgia dangerous?
Trigeminal neuralgia manifests in the regions of the face covered by the distributions of the trigeminal nerve, featuring recurrent, severe pain. The onset of the disorder is sudden and it resolves quickly as well. The pain is usually described as cutting, electric shock-like, burning, or tearing; it is a stubborn, difficult-to-treat pain, colloquially known as the "king of pain" and "the foremost pain in the world," which reflects the extreme level of pain associated with trigeminal neuralgia. Trigeminal neuralgia is generally not fatal, but it inflicts significant harm on the human body, making sufferers feel as if death would be preferable. It causes substantial psychological and physical obstacles and can even trigger the onset of some cardiovascular and cerebrovascular diseases, potentially leading to sudden death. Thus, trigeminal neuralgia is considered a rather dangerous disease.
Causes of hydrocephalus in infants
The occurrence of hydrocephalus in infants involves congenital factors, including poor brain development caused by exposure to medications, radiation, rays, and viral or bacterial infections during the embryonic stage, leading to hydrocephalus. Infant hydrocephalus also includes some acquired factors, such as birth injuries occurring during delivery, and post-birth conditions like inflammation in the brain, tumors, or arachnoid cysts. These conditions can lead to excessive production of cerebrospinal fluid, impaired circulation, or insufficient absorption, resulting in hydrocephalus.
How is cerebral hemorrhage treated?
The treatment for brain hydrocephalus includes conservative medical treatment and surgical intervention. Conservative medical treatment is primarily for patients with a lesser amount of bleeding, using methods such as hemostasis, brain protection, dehydration to reduce intracranial pressure, and maintaining electrolyte balance for symptomatic support treatment. For bedridden patients, it's also necessary to prevent and treat various complications such as pulmonary infections, urinary system infections, and venous thrombosis. Surgical treatment is mainly for patients with a larger volume of bleeding, approximately 30mL of cerebrospinal fluid bleeding, cerebellar bleeding over 10mL, or cerebellar bleeding less than 10mL but causing brainstem compression. Patients with hydrocephalus should actively consider surgery to remove the hematoma. The decision to perform decompressive craniectomy is based on preoperative and intraoperative findings. In some cases, where the brain compression is not severe, or in elderly patients who have poor tolerance for surgery, minimally invasive surgery to remove the hematoma may be considered.