The "old" surgeons who have witnessed and handled real human anatomical cases in the operating room cannot be compared with medical students who learn to read dead objects in textbooks and the anatomy laboratory.
The patient's blood had abnormal fluctuations, causing the embolus to move back and forth. Dr. Hu's vision was sometimes brighter and sometimes darker. Cao Yong, an "old" surgeon, only needed to think about what the junior sister said. Isn't this a sign that the patient may have an aneurysm?
The textbooks on clinical symptoms of aneurysms do not show abnormal blood fluctuations. However, surgeons are different. They can observe such subtle phenomena during surgery, which is the experience advantage of "old" doctors.
Intracranial aneurysm is an abnormal bulge in the intracranial artery, which can be imagined as a blood reservoir. The normal blood vessel diameter can hold a limited amount of blood, and the blood fluctuation is within a fixed limit. After adding a blood reservoir, if there is a slight disturbance, the water in the reservoir is released into the blood vessels or the blood in the blood vessels flows back into the reservoir. Do you think the blood fluctuation will not increase? If the blood fluctuation is larger, it will directly break the wall and cause heavy bleeding.
During surgery, if doctors touch these aneurysms, they can feel the pulsation, which is a typical manifestation of blood fluctuations. The principle is that aneurysms are connected to arteries and receive the pressure of arterial blood vessels. If arteries have pressure pulsation, aneurysms will definitely have it, and because they act as a reservoir, it will appear more intense.
As mentioned last time, the anatomical direction of the internal carotid artery is closely related to the circle of Willis. Any "old" neurosurgeon knows that the probability of aneurysm occurring in the circle of Willis is quite high, and it is a common site for aneurysm. If the aneurysm is relatively small and has not ruptured, the patient's clinical symptoms are not obvious, but the absence of the aneurysm cannot be completely ruled out.
At this point, Cao Yong, an “older” doctor, could quickly recall actual cases for reference and then come up with a more realistic diagnosis. It is reasonable that young doctors cannot do this.
To put it bluntly, being a doctor is a profession that becomes more popular as you get older.
The ophthalmologist’s failure to diagnose Dr. Hu’s condition in a timely manner cannot be said to be the ophthalmology department’s fault.
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Dr. Hu's eye disease is not caused by a simple aneurysm, but is the result of multiple factors, which conforms to the clinical rule that the cause of many diseases cannot be formed by one factor. Aneurysm may be a factor that contributes to the aggravation of Dr. Hu's eye disease, but not the main cause. However, if aneurysm really has an additive effect on Dr. Hu's disease, then the doctor may seize this opportunity to solve Dr. Hu's eye disease.
In any case, the ophthalmology department successfully helped the patient resolve the emergency at the early stage of the disease. The ophthalmology department failed to detect the cause of the disease in other patients. When the patient's condition reached a point where a single department could not solve the problem, it usually required the brainstorming of various medical departments. The patient sought advice from doctors in other departments and came to the neurosurgery department for treatment, which was a normal course of medical treatment for difficult clinical diseases.
Clinical practice is often like this. A patient with a difficult disease who is looking for a good doctor depends mostly on luck. If he is lucky, he will meet a doctor like Cao Yong who can think of an opportunity at the first sight. If he is unlucky, he will miss the best treatment time window for the disease during the process of seeking medical treatment, and it will be useless even if he finds out the disease later.
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