After listening to this, Dr. Hu also raised his own concerns: "Blood vessels are only this big. If you inject blood into the bloodstream, won't it burst?"
Small blood vessels are very easy to burst, which is also the reason why ophthalmologists are reluctant to perform interventional surgery on her. If the embolus falls into a small blood vessel, forcibly injecting too much pressure can easily burst the blood vessel. At that time, not to mention thrombolysis, the eye will be blinded directly.
"So we need to pay attention to the possibility of the collateral circulation providing hemodynamics to this part of the arterial network, as well as the anatomical location of the blood vessels." Xie Wanying said, processing the blood vessel direction diagram that Senior Brother Cao drew for the family members, "The ophthalmic artery starts from here. This is the cavernous sinus of the internal carotid artery. After it comes out from here, it must pass through the dura mater sheath and then enter the skull. The ophthalmic artery is also the first branch of the internal carotid artery. When it runs from the lower and outer sides of the optic nerve to the inside and crosses the optic nerve, it gives off the central retinal artery CRA, which is the location where the doctor temporarily judged that Mr. Hu's disease occurred."
Mr. Liu came closer and looked at the pen in her hand. It was like a painter's, no, like an engineering designer's, which could draw a stroke without any need for modification, which could be praised as the fine work of engineering.
He believed that Cao Yong could draw like this, as he was a famous neurosurgeon. As far as he knew, Dr. Xie was just a medical student. Mr. Liu stared at her intently, and the more he watched her draw, the less he thought her drawings were much different from Cao Yong's.
Cao Yong may be a famous artist, but he only gave a few rough strokes to the family member to create a framework. Xie Wanying's painting was like adding various details and colors to the sketch.
It’s not possible to say which is more challenging, the framework or the details that follow. In fact, both require a certain level of technical skills.
The latter is very impressive as it can draw in detail and be clearly distinguished.
"The retina actually has two vascular networks. One part supplies the inside of the retina and is called the retinal arterial network. The other part supplies the outside of the retina and is called the choroidal vascular network. The central retinal artery is divided into three sections. The first is the intraorbital segment, which extends from the starting point to pass through the dura mater sheath around the optic nerve. The second is the intradural segment, which is between the optic nerve and the dura mater sheath. The intraneural segment is inside the optic nerve. This is where the central retinal artery and the retinal artery branches connect, the optic nerve**." When Xie Wanying came to the key point, she took out a red pen and drew a circle.
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Mr. Liu was fascinated by the pictures, which shows that as long as the anatomical drawings are well drawn, they can be no worse than paintings in art academies and can be just as attractive.
"For some people, their retinas are supplied by the ciliary retinal arteries, which are branches of the posterior ciliary artery. So Dr. Hu had to thoroughly check these blood vessels to understand where the problem is. At the optic nerve head, the diameter of the central retinal artery is about 160 um. There are several narrow parts of this artery, one is where it passes through the cribriform plate, and the other is where the proximal end passes through the dura mater and enters the optic nerve. These narrow parts may be the location of the embolus we are looking for, because emboli are most likely to be entrapped in these places."
"After finding the plug, how do you say we should flush it out?" Mr. Liu followed Xie Wanying's instructions without hesitation.
Doctor Hu could tell that my husband understood and was listening with great interest, and he couldn't help but smile. Having said that, this student Xie did explain the anatomical diagram very well. Now it depends on how Xie explains the key issues and the key solution strategies.
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