Everyone's heart skipped a beat. "What could it be if it wasn't a bleeding focus..." The anesthesiologist was a little doubtful. He has performed hundreds of hematoma removal surgeries. In the past, when this happened, it was always a new bleeding focus! Xu Qiu shook his head and said: “The bleeding was so fast. If it was a bleeding focus, at least seven or eight cerebral blood vessels would have to rupture together to cause such a large amount of bleeding. in addition-- Her brain tissue was squeezed out! " In this case, either Guan Chuyu has a tumor with a rich blood supply in his head. Either——
It’s the abnormal arterial network! Xu Qiu made a quick decision and said: "Do an intraoperative cerebral angiography." Director Lin was stunned for a moment. He immediately realized something and said, "Quickly, arrange the angiography!" Ten minutes later, Everyone looked at the angiography images on the screen with shocked expressions. Bilateral intracranial artery terminal occlusion, There are a large number of abnormal blood vessel networks at the base of the skull, which look like clouds of smoke under angiography. A diagnosis immediately came to the minds of experienced doctors - moyamoya disease! Moreover, it is hemorrhagic moyamoya disease! The operating room was silent. Everyone stared in astonishment, with disbelief written all over their faces. Rare disease, moyamoya disease! Scientific name: Abnormal vascular network disease at the base of the brain. It is a cerebral hemorrhagic or ischemic disease caused by primary bilateral internal carotid artery distal stenosis and occlusion and abnormal vascular network expansion at the base of the brain. in short, The main blood supply vessel to the patient's brain is blocked! In order to ensure the blood supply to the brain, the body compensatoryly develops many scattered small blood vessel branches. These scattered small blood vessel branches are densely developed, and after being coated with contrast media, they look like diffuse smoke, so it is called moyamoya disease. This is a rare disease, and the hemorrhagic form is more common in adults.
No one expected that eight-year-old Guan Chuyu would have hemorrhagic moyamoya disease! "We have to think about it in the long term..." "Moyamoya disease requires intracranial and intracranial vascular bypass. There are many types of surgeries. This surgery is amazing!" "This child is too young. Moyamoya disease in children is very difficult to treat surgically!" Everyone's faces were ugly. For moyamoya disease, medical treatment is ineffective. Evidence-based medicine has confirmed that surgical bypass surgery is the only treatment that has good results. However-- Extracranial and extracranial vascular bypass is the specialty of a few brain surgery experts. not to mention, This is moyamoya disease in children! "or……" Someone was about to persuade Xu Qiu to close his skull and finish the operation. But I found that Xu Qiu's expression was still calm at this moment, as if he had everything in his hands! "Contact the family to confirm whether a bridge needs to be built." The next moment, Xu Qiu's understatement came. Everyone present was stunned. "Doctor Xu, do you want to do this surgery?" "This is completely different from neuroendoscopic resection, and children's brains are still developing, so the requirements for surgery are extremely high -" Suddenly, a voice interrupted these questions. Director Lin swallowed and said with a little excitement: "Why are you panicking? Do you understand or does Xu Qiu understand? Do as he says!" After finishing speaking, he looked at Xu Qiu and asked urgently: "What surgery are you planning to do?" There are three ways to treat moyamoya disease. direct vascular reconstruction, indirect vascular bypass, and combined vascular reconstruction. However, each of the three surgeries has pros and cons. Direct vascular reconstruction, such as superficial temporal artery-middle cerebral artery bypass grafting. Its advantage is that it can quickly establish collateral channels of main branch vessels, immediately improve cerebral ischemia, and immediately correct bleeding. but,
Guan Chuyu is a child and the recipient artery is very small, making the operation difficult. In addition, the extent of improvement that direct revascularization can achieve is limited. And indirect vascular bypass—— Although it can induce the formation of new blood vessels on a large scale, its onset of action is very slow! From the completion of the surgery to the establishment of new blood vessels, it may take three to five months. During this period, Guan Chuyu may suffer from cerebral infarction or cerebral hemorrhage at any time. As for the final combined vascular reconstruction. Although it has the advantages of the first two, it has raised the difficulty of the operation to a level that few people can handle! Currently, those who can perform combined surgeries are basically brain surgery experts from Little Japan... Moyamoya disease was originally discovered and named by the Little Japan Country. They have the world's largest cerebrovascular disease treatment center and are the world's leaders in this regard. The famous brain surgeon who went to Linhai No. 1 Hospital for academic exchanges soon happened to be good at this operation. In addition, not many people in China can perform combined surgeries. Director Lin felt a little sorry. If Guan Chuyu had been sent a few days later, he might have been able to get a better curative effect by having the famous doctor from Xiaori Kingdom perform the surgery... "Build a bridge directly or indirectly?" Director Lin asked. Xu Qiu glanced at his system silently. Master-level extracranial and intracranial vascular bypass surgery. Difficult task: Discover a difficult disease and cure it. Unexpectedly, in a twists and turns, the experience baby was lying on the stage. Guan Chuyu, who seemed to be suffering from acute epidural hemorrhage, turned out to be suffering from moyamoya disease! After a while, Xu Qiu recovered from the system and said in a slow and steady voice: "Combined surgery." At this moment, everyone was completely shocked. Xu Qiu can actually perform combined extracranial and extracranial blood vessel bypass surgery? ! Director Lin's voice became a few degrees louder: "Are you sure?!" He was almost overwhelmed by the surprise. Director Lin originally only wanted to make another instructional video on hematoma removal, but in the end he actually got the chance to learn about moyamoya disease combined with vascular bypass surgery... This feeling, It's like I've been looking for a third-level movie for a long time, and every video has the name Black Cat Sheriff.
Once opened, it's not just level 3, it doesn't even have a code! … Not long after, the circulating nurse hurried over. "The family has signed the surgery consent form and can continue with the next surgery!" Everyone in the operating room breathed a sigh of relief. Every operation must be carried out strictly in accordance with the plan discussed before the operation. Even if other problems are discovered during the operation, don't mind your own business. There was once a hospital that conveniently treated a mother's hemorrhoids during the delivery process. Later, the media and family members maliciously hyped the incident and exaggerated it as "the mother's anus was sewn", which seriously aggravated the doctor-patient conflict... Now, after obtaining the consent of the family, the operation was legal and compliant. The operating room was quiet. Everyone looked at Xu Qiu, waiting for the operation to begin. They were very curious about how Xu Qiu would carry out the combined surgery! The next moment, everyone was shocked when they saw the impact point of Xu Qiu's scalpel, their faces filled with horror. "Can this happen?!" someone exclaimed.