Release date: 2017-07-19
Recently, Zhang Xiaohua, deputy director of the Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, and Wang Yu, deputy chief physician, successfully performed a timely microsurgical treatment for a patient with massive brainstem cavernous blood vessels and severely compressed brain stem. On the second postoperative day, the patient's right hand resumed its function. The patient is currently recovering.
The 18-year-old Xiao Pan started to appear two years ago when he did not know the words briefly, and suddenly did not know what the other party said when he spoke. At the time, he found three cavernous hemangiomas in the brain, two of which caused absence of seizures. s reason. The most deadly is the third tumor, which is growing in the medulla of the brainstem. The huge risk of brain stem surgery made Xiao Pan's parents deterred, and the intense study in high school made them finally choose conservative observation.
In this way, Xiao Pan took the three "time bombs" in his brain and insisted on studying for the past two years while taking drugs to control seizures. He wished to participate in the college entrance examination this year. On July 4, Xiao Pan suddenly fell into a coma. One hand could not move. The film was shot at the local hospital to know that the most deadly hemangioma in the brain stem was bleeding. Xiao Pan’s parents hoped to take the child to Shanghai Renji Hospital. For the narrow part of the brainstem, the hospital arranged a high-resolution brainstem nuclear magnetic resonance special sequence scan. In the ultra-clear image, you can see that a hemorrhagic lesion oppresses the brainstem of the medulla of the brain to nearly 2/3 of the space. The amount exceeds 10 ml, and this is not shown on the film brought by the family.
According to Wang Yu, the brain stem is deep in location, surrounded by many important neurovascular vessels. It is called the “life center†and is the hub of the brain, cerebellum and spinal cord. The medulla and pons have cardiovascular movement, breathing and swallowing. The reflex center of important physiological activities such as vomiting. If these centers are damaged, it will cause serious obstacles to heartbeat, blood pressure and even breathing, which is life-threatening. The literature shows that the amount of brainstem hemorrhage is more than 5 ml, the mortality rate is about 90%, and the amount of bleeding exceeds 10 ml and can not be treated in time. The mortality rate is 100%.
On July 8th, Zhang Xiaohua and Wang Yu combined surgery to use the super-microscopic separation technique under the 3D high-definition operating microscope to gently shift the superficially important neurovascular vessels, accurately revealing the extremely deep position of the brainstem bridge and Hemangiomas on the surface of the medulla oblongata, then carefully avoiding the vital cardiovascular respiratory center in the brainstem, and successfully cut the tumor and cleared the hematoma in the brainstem in just over one hour. During the operation, the patient's vital signs remained stable, normal breathing resumed after surgery, and vital signs were stable. A review of CT showed that the hematoma that had pressed the brain stem had disappeared. On the second postoperative day, the patient's right hand miraculously resumed activity.
According to Zhang Xiaohua, the operation of the brainstem area was once the forbidden area of ​​neurosurgery. Now with the application of micromanipulation technology and the rapid development of surgical instruments and equipment, the success rate of brainstem surgery has been greatly improved, but it is still One of the most difficult neurosurgical procedures.
Source: Health News Network
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