The place where cerebrospinal fluid is produced is the lateral ventricle. In addition to the lateral ventricle, there are third ventricle and fourth ventricle.
The ventricular system can be called the "pool" that holds the cerebrospinal fluid, which runs from the lateral ventricle to the third ventricle to the fourth ventricle.
How the cerebrospinal fluid is recovered is through the arachnoid granules and then into the venous system.
The above cycle sounds like a very closed environment.
That's right. The blood-brain barrier that we often hear, to be precise, includes three barriers: blood-brain, blood-cerebrospinal fluid, and cerebrospinal fluid-brain barrier. The cerebrospinal fluid environment is so closed, which can be seen.
It is more complicated to deconstruct how the "closedness" and "barrier" come about. There are interpretations at the level of cytology and interpretations of mechanophysics.
Speaking of the current patient, hydrocephalus, hydrocephalus is the area of "water" in the brain, and there is too much cerebrospinal fluid. There is too much cerebrospinal fluid, which means that the "water" may be secreted too much, there may be a problem with the recycling mechanism, or the flow path may be blocked, and the "water" body cannot circulate smoothly.
Clinical manifestations, ct showed expansion of the ventricular system and or expansion of the subarachnoid space, compression of normal brain tissue is often accompanied by brain atrophy. What is brain atrophy? Just mentioned the disease of cerebellar atrophy, it will only be more serious than cerebellar atrophy.
Typical symptoms: adult patients have headache, nausea and vomiting, abnormal mentality, drowsiness and mania, ataxia, fecal incontinence, etc.
In view of the above we have talked about a lot of problems about cerebrospinal fluid, we can know that if the hydrocephalus is caused by other diseases, such as tumors, it may be solved with a surgical knife.
However, the most common hydrocephalus patients in clinical practice may not have a clear and visible cause. If it involves more complicated secretory problems, it is natural to use internal medicine to solve it better than surgery.
Surgery does not cure the root cause, and there is a fear that there will be frequent recurrences, so why let the patient suffer for nothing.
Surgical means must be used, and it is necessary to clarify the cause of the disease, which can be solved by surgery.
For example, ventriculoscopic third ventriculostomy is aimed at the obstruction of the circulation of cerebrospinal fluid in the third ventricle through the midbrain aqueduct to the fourth ventricle. A hole is made directly in the third ventricle to direct CSF to the prepontine cistern.
If the cause cannot be identified or the cause cannot be solved by surgical means, surgery also has a conservative surgical treatment plan, which is the most commonly referred to as cerebrospinal fluid shunt.
Time is tight, a group of neurosurgeons entered the ward first to make rounds.
Dr. Jin waited outside, and waited for them to check his ward before going in.
From the countdown to the last bed, the friend of Dr. Jin, a patient in the 23rd bed, was found. The patient was a woman in her thirties and forties. Preliminary judgment may be hydrocephalus caused by some kind of infection, because no other cause can be found for the time being. However, after finding out that there was a cerebral arteriovenous malformation, it was hard to say which of the two came first.
The patient's current condition is relatively serious, and drowsiness has already occurred.
Here comes a group of juniors and juniors.
During the ward rounds, Huang Zhilei asked the juniors to go up to perform neurosurgery examinations on the patients, which was regarded as an on-site examination.
For patients with hydrocephalus, according to what classmate Pan and his classmates think, just looking at the patient's head can't tell what the condition of hydrocephalus is.
If you want to thoroughly check ataxia, the patient is lethargic, and you want the patient to open his eyes to answer questions, etc. The patient cannot cooperate with the doctor.