Returning to ’90s, She Became Famous in Major Surgical Fields

   Chapter 2858 [2858] Key points of effect

   must face it.

  If he didn't dare to fight, Song Xuelin would definitely look at them with those eyes again: Just you? Pei claims to be in the same class as classmate Xie?

Raising his head, Pan Shihua faced the monitor screen, his eyes locked on the area where the main knife swept again, and said, "From the current picture, the direction of the cerebrospinal fluid in this place shows a sign that a vortex is slowing and spinning in place. The flow below is not smooth. What Yingying said about the trumpet-shaped outlet of the midbrain aqueduct actually refers to the expansion of the outlet end of the midbrain aqueduct after the fourth ventricle dilates."

   "It turns out that the midbrain aqueduct originally grew into a trumpet-shaped abnormality, is that so?" asked Sun Yubo, who is not a neurosurgery specialist. He thought it was such a cause when he first heard it, but now it doesn't sound like it.

   Mainly because his fellow Huang Daxia didn't come out immediately to explain whether it was true or not.

  In terms of anatomy, looking at the anatomical map, you will find that the midbrain aqueduct is a slender, long and somewhat tortuous tube, unlike the lateral ventricle to the third ventricle that only passes through a hole such as the interventricular foramen. Such a structure makes it difficult for the hard mirrors we mentioned earlier to pass through, and we can only use soft mirrors like earthworms or caterpillars to twist and twist slowly.

  As Pan said, the fourth ventricle connected to the bottom of this long thin tube has too much water and overflows and goes up. The lower end of the tube is stretched up, and the outlet of the stretched tube is naturally shaped like a horn.

   In this case, is there something in the fourth ventricle that is blocked near the outlet of the midbrain aqueduct? I mentioned before that this case did not have a space-occupying obstruction, and it has been determined to be a traffic obstruction, which is more likely to be a problem in the subarachnoid space below the fourth ventricle.

   The subarachnoid space of the brain is the space between the pia mater and the arachnoid, so it is very deceiving to say that it is a cavity, making people think that it is a cavity similar to the oral cavity, but it is not. More precisely, it is an extended water network covering channels and cisterns. The channels are located throughout the brain's sulci and fissures. The larger areas are called cisterns and are usually called cisternae.

   This water network receives the cerebrospinal fluid from the fourth ventricle, allowing the cerebrospinal fluid to function throughout the brain. At the same time, the subarachnoid space of the brain communicates with the subarachnoid space of the spinal cord, allowing the cerebrospinal fluid to continue to flow to the spinal cord. We talked about how the spinal anesthesia puncture into the subarachnoid space and the flow of cerebrospinal fluid came from here.

  ETV is a fistula at the bottom of the third ventricle, that is, a hole is made to allow the cerebrospinal fluid to be diverted directly into the underlying cistern to solve the problem of cerebrospinal fluid accumulation.

   From the above, we can know that the focus of this operation to be effective should be on the cause of proximal ventricular obstruction. This means that if the hydrocephalus is caused by the poor outflow from the fourth ventricle to the prepontine cistern, it is not necessarily a space-occupying obstruction, such as some other factors that narrow the subarachnoid space. At this time, the shunting of the hole can allow the cerebrospinal fluid in the ventricle to bypass the obstructed segment and flow directly to the cerebral cistern to continue the circulation. Of course, it is effective.

   This matter is known to all neurosurgeons.

   Huang Zhilei couldn't possibly not know. He glanced at Dr. Sun Yubo, a fellow non-neurosurgery specialist: Don't talk nonsense if you don't understand. I don't come out to explain it doesn't mean I don't understand such a superficial knowledge point.

where is the problem? How can you judge that it is a proximal ventricular obstruction and not a problem with the subarachnoid space elsewhere?

   (end of this chapter)

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