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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.
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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.
Hydrocephalus Clinical Manifestations
In adults, hydrocephalus can be of the normal pressure type, mainly characterized by unsteady gait, slow responses, urinary and fecal incontinence, among others. There is also high-pressure hydrocephalus, which mainly presents as increased intracranial pressure, with the most common symptoms being headache, vomiting, papilledema, and ataxia. In children and infants, hydrocephalus has its own characteristics. In addition to some of the adult symptoms, there are also anomalies such as an abnormally increased head size, bulging fontanelles, "sunset" eye sign, intellectual and cognitive impairments, decreased vision, visual field defects, decreased hearing, epilepsy seizures, and more.
How is hydrocephalus treated?
Hydrocephalus is caused by the continuous increase of cerebrospinal fluid in the ventricular system of the brain. There are two types of hydrocephalus: obstructive hydrocephalus and communicating hydrocephalus, each with different treatment methods. Obstructive hydrocephalus is caused by obstructions such as tumors or blood clots, so removing tumors or clearing blood clots can relieve the obstruction and treat the hydrocephalus. On the other hand, communicating hydrocephalus usually has no obstruction; it is primarily caused by excessive production or insufficient absorption of cerebrospinal fluid. A common treatment is ventriculoperitoneal shunt surgery, which diverts cerebrospinal fluid from the ventricles to the abdominal cavity to treat hydrocephalus.
Is brainstem hemorrhage dangerous?
The brainstem is the central hub of life in the human body, controlling vital functions such as blood pressure, pulse, respiration, body temperature, and consciousness. Bleeding in this area is extremely dangerous and is a life-threatening condition. Clinically, it has a high mortality and disability rate. For hemorrhages larger than 5 mL, most patients will succumb to central respiratory and circulatory failure within 48 hours. Even if the bleeding is less than 5 mL, although aggressive resuscitation may save the patient's life, most will suffer from severe brain dysfunction such as hemiplegia, aphasia, or a vegetative state. Therefore, brainstem hemorrhage is very dangerous.
Can brainstem hemorrhage be operated on?
The brainstem is the center of human life, controlling vital functions such as breathing, circulation, heart rate, and blood pressure. Once bleeding occurs, patients often experience unstable vital signs, deep coma, and can die from brain function failure within a short period. Previously, it was believed that the brainstem was a no-go zone for surgery, and treatment for brainstem hemorrhage was primarily conservative medical therapy. However, with the continuous improvement of medical technology, neurosurgery departments in many top-tier hospitals have made significant achievements in minimally invasive or open surgeries for brainstem hemorrhages. Therefore, surgery for brainstem hemorrhage is not impossible and can be considered under specific circumstances.
Early manifestations of infant hydrocephalus
Infant hydrocephalus initially manifests as an enlarged head, beginning from birth with progressive increase in head circumference that is disproportionate to body growth. Upon examination, bulging fontanelles, thin scalp, and clearly visible scalp veins can be observed, with widened or even separated sutures. Additionally, due to increased intracranial pressure, symptoms such as irritability, recurrent vomiting, refusal to eat, abnormal behavior, and seizures may present as early indicators.
Is trigeminal neuralgia severe?
Trigeminal neuralgia is one of the most common, stubborn, and excruciatingly painful diseases, known by patients as the "world's most severe pain." The intensity of the pain during an episode can surpass even that of childbirth. When the pain is severe, patients dare not speak, eat, or sleep, causing immense suffering in their lives. In extreme cases, the unbearable pain leads to suicidal thoughts. Therefore, trigeminal neuralgia is also referred to as the "non-lethal cancer," a serious neurological disorder.
Is trigeminal neuralgia severe?
Trigeminal neuralgia is often described by people as the "world's first pain," highlighting the severity of this condition. Patients usually experience excruciating pain in the areas of the head and face served by the trigeminal nerve during activities such as washing their face, brushing their teeth, eating, drinking, combing their hair, and even in a state of rest. The pain can feel like cutting, burning, tearing, or electric shocks, making it unbearable and extremely agonizing. Clinically, trigeminal neuralgia is characterized by a sudden onset, long duration of illness, and a very slow, or even impossible, recovery. Therefore, those suffering from trigeminal neuralgia often face tremendous physical and psychological challenges. It is a serious disease.
How painful is trigeminal neuralgia?
The trigeminal nerve is located on the human face, and trigeminal neuralgia is a common neurological disorder. The most prominent symptom of this disorder is pain that feels like needle pricks or knife cuts. This pain usually occurs very suddenly and is extremely intense. When the pain occurs, patients cannot perform any movements related to the face, severely affecting their quality of life. Moreover, sometimes even a minor movement can trigger repeated episodes of pain, placing the patient in constant severe discomfort. Therefore, trigeminal neuralgia is also referred to as "the worst pain in the world."