If he didn't dare to fight, Song Xuelin would definitely look at them with that look again: Are you the only ones who deserve to claim to be in the same class as Xie?
Raising his head, Pan Shihua faced the monitor screen, his eyes locked on the area where the surgeon was scanning again, and said: "Judging from the current picture, the direction of the cerebrospinal fluid in this place shows signs of a slow vortex and spinning in place. It shows that in
The flow rate below is not smooth. The trumpet-shaped outlet of the midbrain aqueduct that Yingying mentioned actually refers to the expansion of the outlet of the midbrain aqueduct after the fourth ventricle is dilated."
"It turns out that the midbrain aqueduct originally grew into a trumpet-shaped abnormality, is it like this?" Sun Yubo, who is not a neurosurgery specialist, asked. When he first heard about it, he thought it was such a cause, but now it doesn't sound like it.
Mainly because his fellow countryman Huang Daxia didn't come out immediately to explain whether it was true.
In anatomy, if you look at the anatomical atlas, you will find that the midbrain aqueduct is a long, slender pipe with a twist in the inside. It is not like the lateral ventricle to the third ventricle that just passes through an opening such as the interventricular foramen. This structure causes what we said before
The hard lens is difficult to pass through, so you can only use a soft lens to slowly twist it like an earthworm or caterpillar.
As Pan said, if there is too much water in the fourth ventricle connected to the lower part of this long thin tube, the water will flow upward and expand the lower end of the tube. The outlet of the enlarged tube will naturally be shaped like a trumpet.
In this case, is there something in the fourth ventricle that is blocked near the outlet of the midbrain aqueduct? As mentioned before, no space-occupying obstruction was detected in this case. It has been determined to be a communicating obstruction, and it is more likely to be below the fourth ventricle.
Problems with the subarachnoid space of the brain.
The cerebral subarachnoid space is the space between the pia mater and the arachnoid membrane, so it is very confusing to say that it is a cavity. People think that it is a cavity similar to the oral cavity, but it is not. More accurately, it is
A water network extending in all directions covers water channels and pools. The water channels spread throughout the sulci and fissures of the brain. The larger areas are called pools and are usually called cerebral cisterns.
This water network receives the cerebrospinal fluid from the fourth ventricle, allowing the cerebrospinal fluid to spread throughout the brain. At the same time, the brain subarachnoid space is connected to the spinal cord subarachnoid space, allowing cerebrospinal fluid to continue to flow to the spinal cord. The spinal anesthesia puncture we have talked about
The cerebrospinal fluid flowing out of the subarachnoid space comes from here.
ETV surgery is to create a fistula in the bottom of the third ventricle, that is, to make a hole to allow cerebrospinal fluid to flow directly into the lower brain pool to solve the problem of cerebrospinal fluid stasis.
From the above, we can know that the focus of this operation should be on the cause of proximal ventricular obstruction. This means that if the hydrocephalus is caused by poor outflow from the fourth ventricle to the prepontine cistern, it is not necessarily necessary to
If there is a space-occupying obstruction, for example, some other factors have narrowed this subarachnoid space. The hole shunt at this time can allow the cerebrospinal fluid in the ventricle to directly bypass the obstructed segment and flow to the cerebral cistern to continue to maintain circulation. Of course,
It worked.
All neurosurgeons know this.
It was impossible that Huang Zhilei didn't know. He glanced at Dr. Sun Yubo, a fellow non-neurosurgery fellow: If you don't understand, don't talk nonsense. Just because I won't explain it doesn't mean that I don't understand such a superficial knowledge point.
What's the problem? How do you tell if it's proximal ventricular obstruction rather than a problem in the subarachnoid space elsewhere?
