Aortic aneurysm and aortic dissection are diseases that are difficult to detect clinically in daily life, so most of the time it is too late for the patient to go to the hospital for treatment.
The junior sister is amazing. The most powerful thing about the junior sister is that she is single-minded. Huang Zhilei sighed with emotion.
While everyone was thinking about what to do with this trap, Xie Wanying stood in front of the light board and kept studying the MR film.
Duan Sanbao stood behind her and watched the movie with her.
Maybe the two of them discussed the patient's case in the afternoon and argued about what should be argued. Now watching the film, silence is golden.
The other teachers and bosses were bombarded by the information about this patient's serious illness, and their brains were a little irritated, so they stood around and argued endlessly.
"Coma. This MR film is definitely not accurate. If we take more pictures, the dissection should have torn into the innominate artery or the left common carotid artery."
The innominate artery and the left common carotid artery have been mentioned before. They are the branches from the aortic arch and connect the important main cerebral blood vessels. It can be said that if something goes wrong with these two blood vessels, the brain tissue will be cut off from blood and nutrients. Cerebral ischemia
It caused the patient's consciousness disorder, and the direct clinical manifestation is that Aki's mother is now unconscious.
How does aortic dissection cause the innominate artery and left common carotid artery to "cut off blood"?
Here are some other characteristics of aortic dissection. It is similar to aortic aneurysm: it is afraid of massive bleeding like a balloon bursting. It will form a large hematoma and compress nearby organs and tissues. For example, if it compresses the nearby esophagus, it will cause
Difficulty swallowing, compression of the superior mesenteric artery, may lead to intestinal necrosis.
But it is obvious that aortic dissection can widely cause various "blood cutoff" symptoms in organs other than the above-mentioned reasons. The obvious difference between aortic dissection and aortic aneurysm is that the adventitia is not broken, and the blood flows into the dissection.
.
If there is blood in the dissection, it will squeeze the original true lumen of the blood vessel, causing the blood flow in the true lumen to drop sharply. The most intuitive clinical manifestation is the blood pressure difference between the two limbs of the patient. The true lumen of the limb that is compressed by the dissection is
There is less blood in the cavity, resulting in low blood pressure measured.
To put it more deeply, low blood pressure is definitely not a good thing. Anyone who studies medicine knows that it means that a certain part of the body is ischemic.
This is indeed the case. Even if the blood flows through the dissection, it seems that it is not lost. In fact, after this part of the blood escapes into the dissection, less blood flows into the true lumen of the blood vessel. The dissection is a fake, not a real blood vessel, and it does not connect with the main blood vessels of the organ.
, blood needs to go from the true cavity to the organs to supply organ nutrition. The blood that goes to the dissection slips away and fails to reach the organs. This will "cut off" the blood vessel segment where the dissection occurs. As long as the main source of blood supply to other organs
The vascular trunks that are related to the dissecting blood vessels in this section will all be "blood cut off". These organs are naturally in a state of ischemia, which is also called poor perfusion and insufficient perfusion in medicine.
For example, if one or both renal arteries are involved, the patient will develop anuria, hematuria, or severe renal failure.
Involvement of the celiac artery may lead to irreparable consequences of liver and spleen infarction.
The arteries of the lower limbs are affected, ranging from chills to severe pain and necrosis. This is the reason why Aki’s mother’s limbs are cold.
If the spinal cord is "cut off" from blood, symptoms may appear in the corresponding spinal cord segment, ranging from mild lumbar pain to paraplegia.
The innominate artery mentioned above, the left common carotid artery, was "pinched", and central nervous system symptoms appeared.
