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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
Precursors to neuroblastoma recurrence
For neuroblastoma, if recurrence occurs, the patient may show symptoms like recurrent headaches, dizziness, nausea, and vomiting. Additionally, if the optic nerve is involved, there may be a decrease in vision and visual field defects. Even the possibility exists that the tumor could recur, increase in size, and compress surrounding important blood vessels and nerves, leading to an increase in intracranial pressure, which manifests as worsening of the original symptoms of headaches and dizziness. Once such symptoms occur, it generally suggests a high likelihood of neuroblastoma recurrence. If it causes symptoms such as hemiplegia and aphasia, it can generally be confirmed.
What should the blood pressure control be for brainstem hemorrhage?
For patients with brainstem hemorrhage, it is important to maintain stable blood pressure after the bleeding. The ideal blood pressure should be controlled between 130/80 and 140/90. This is because the blood pressure should not be controlled too low. If the blood pressure is too low, it can lead to insufficient perfusion pressure in the brain tissue or brainstem, thus exacerbating the state of brain tissue ischemia and hypoxia, which may aggravate the local brainstem ischemia and cause new brainstem infarcts. Additionally, blood pressure should not be too high, as excessively high blood pressure can lead to primary brainstem hemorrhage, coagulation dysfunction, and situations where bleeding is difficult to stop. Moreover, it can cause rebleeding of the brainstem, also known as secondary hemorrhage, which, once it occurs, can be life-threatening for the patient.
The difference between cerebral hemorrhage and subarachnoid hemorrhage
There is a significant difference between cerebral hemorrhage and subarachnoid hemorrhage. For subarachnoid hemorrhage, the specific causes are mainly divided into two types. The first cause is due to trauma, violent strikes, car accidents, or falls from heights, leading to localized vascular rupture and extensive subarachnoid hemorrhage. It generally presents as obvious high-density shadows in the ventricular system or cisterns. The occurrence of subarachnoid hemorrhage often leads to symptoms such as headache, dizziness, neck stiffness, and positive meningeal irritation signs. The other situation is spontaneous subarachnoid hemorrhage, most often due to intracranial aneurysms or arteriovenous malformations. Cerebral hemorrhage is primarily due to hypertensive cerebral hemorrhage, which is more likely to occur, mostly seen in the bilateral basal ganglia, presenting as localized high-density shadows.
What tests are done for a cerebral infarction?
For patients with cerebral infarction, it is recommended to take the patient to a local hospital for timely treatment during the acute phase. A cranial CT scan or MRI should be performed to help assess the current situation. Cranial MRI plays an important auxiliary diagnostic role in identifying the specific location, extent, and severity of the cerebral infarction. It is advised to perform a cranial MRI during the acute phase for a clear diagnosis, and then decide the next step of the treatment plan based on the situation. Within the surgical window, thrombolytic therapy can be applied to achieve dissolution of the clot. If the optimal timing for thrombolysis has been missed, it is recommended that the patient be hospitalized to receive treatment, including intravenous drips, brain-nourishing drugs, nerve nutrition, and medications that invigorate blood circulation and remove blood stasis, to help improve the state of ischemia and hypoxia in the brain tissue.
Glioma Symptoms
For patients with glioma, they often exhibit certain degrees of headache and dizziness, with headaches typically located bilaterally in the frontal or temporal regions. The nature of the pain is relatively sharp, manifesting as intermittent attacks that progressively worsen over time. Long-standing gliomas easily induce a notable increase in intracranial pressure, presenting with severe headaches, nausea, vomiting, and even a decrease in vision or visual field defects. When the glioma is located in the parietal lobe and affects important motor function areas, it can lead to unilateral or bilateral limb weakness, numbness, pain, and possibly even trigger hemiplegia.
Trigeminal neuralgia symptoms display
Trigeminal neuralgia typically manifests as sudden, severe facial pain, most often occurring in areas such as the upper lip, nostril, or corner of the mouth. These areas are prone to forming trigger points, and touching or stimulating these points can provoke an episode of pain. Most often, pain attacks occur when the patient is talking or eating, causing sudden cessation of the activity. The patient may experience unilateral facial muscle spasms, and reactions such as frowning, clenching teeth, opening the mouth wide, covering the eyes, or vigorously rubbing the face with the palm of the hand, leading to rough, thickened skin and eyebrow hair loss.
Causes of Cerebral Infarction
The specific causes of cerebral infarction are mostly seen in older patients with several underlying diseases, such as hypertension, diabetes, and hyperlipidemia. Over time, without well-controlled blood pressure, blood sugar, and blood lipids, arteriosclerosis can easily form within the blood vessels, or atherosclerotic plaques can develop. Once the plaque forms, under certain triggers, the unstable detachment of the vascular plaque can occur. The embolus then moves with the blood flow into the brain and lodges in a narrowed part of the vessel, causing local blood supply areas to experience narrowing or blockage. At this point, a cerebral infarction is likely to form, leading to ischemia, necrosis, and degeneration of the brain tissue supplied by the vessel, resulting in a softening lesion. On a cranial CT scan and MRI, a local low-density shadow can be observed, which is the specific cause of the cerebral infarction.
Symptoms of hydrocephalus in children
For pediatric hydrocephalus, a range of specific symptoms and signs will appear. For instance, children may repeatedly complain of headaches, dizziness, nausea, vomiting, accompanied by a strong sense of vertigo. Through physical examination, it can be found that the head circumference of the child is significantly larger than that of normal children, with the anterior fontanelle full and bulging. Special physical examinations may reveal the presence of a sunset sign or a cracked pot sound. In addition, some children may exhibit certain levels of cognitive dysfunction, lower intellectual development, significantly lagging behind peers, and they might also show instability in walking, swaying back and forth, prone to falling, or even experience urinary and fecal incontinence.
How is hydrocephalus treated?
If hydrocephalus is suspected, it is advised to first visit a local hospital for an emergency cranial CT scan to determine the type and severity of the hydrocephalus. This helps identify the main causes of the condition and whether it is communicating or non-communicating hydrocephalus. Treatment plans should then be based on the patient's symptoms and physical signs. For those with obvious clinical symptoms of obstructive hydrocephalus, surgery is often recommended. Clinically, a ventriculoperitoneal shunt surgery is generally chosen. Through surgical intervention, original symptoms can gradually alleviate or even disappear, and the morphology of the ventricular system can progressively return to normal.
What department should I go to for a cerebral infarction?
When a patient suffers a stroke, it is advised to promptly visit a local hospital and consult a neurologist to assess the condition. Often, when an acute stroke occurs, treatment can be administered through thrombolysis. If the window for thrombolytic therapy is missed, conservative pharmacological treatment is recommended. Clinically, it is generally recommended to treat patients with medications that enhance brain function, promote blood circulation to remove blood stasis, and nourish the nerves. Patients’ vital signs should be closely monitored, and dynamic reassessment through head CT or MRI should be conducted to observe changes in the patient's condition. In cases of extensive stroke, it may be necessary to transfer the patient to neurosurgery for decompressive craniectomy surgery.