Aortic aneurysm and aortic dissection are diseases that are difficult to detect clinically on a daily basis, so by the time patients go to the hospital for treatment, it is mostly too late.
Junior sister is amazing. Another amazing thing about the junior sister is her stubbornness. Huang Zhilei sighed.
While everyone was thinking about what to do with this pit, Xie Wanying was standing in front of the light board and studying the MR film.
Duan Sanbao stood behind her and watched the movie with her.
Maybe the two of them had discussed the patient's case in the afternoon and had argued about it, so now they could keep silent while watching the film.
The other teachers and senior leaders were bombarded with information about the patient's serious illness. They felt a little irritated and stood by arguing endlessly.
"He's unconscious. This MRI is definitely not accurate. If we take another picture, the dissection should have torn the innominate artery or the left common carotid artery."
The innominate artery and left common carotid artery have been mentioned before. They are branches of the aortic arch and connect to important cerebral vascular trunks. It can be said that if anything goes wrong with these two blood vessels, the brain tissue will be cut off from blood nutrition. Cerebral ischemia causes the patient to have impaired consciousness, and the direct clinical manifestation is that Yaxi's mother is now in a coma.
How does aortic dissection cause blood flow to the innominate artery and left common carotid artery to be cut off?
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Here we will talk about some other characteristics of aortic dissection. It is similar to an aortic aneurysm in that it may rupture like a balloon and cause massive bleeding. The formation of a ball-sized hematoma compresses nearby organ tissues. For example, compression of the nearby esophagus may cause difficulty in swallowing, and compression of the superior mesenteric artery may cause intestinal necrosis.
However, it is obvious that the reasons why aortic dissection can cause a wide range of "blood cut-off" symptoms in organs are not the ones mentioned above. The significant difference between aortic dissection and aortic aneurysm is that the adventitia is not ruptured and the blood flows into the dissection.
When there is blood in the dissection, it will squeeze the original true lumen of the blood vessel, causing a sharp drop in blood flow in the true lumen. The most intuitive manifestation in clinical practice is the blood pressure difference between the patient's two limbs. There is less blood in the true lumen of the blood vessels in the limb on the side compressed by the dissection, resulting in low measured blood pressure.
To go deeper, low blood pressure is definitely not a good thing. Anyone who studies medicine knows that it means that some part of the body is lacking blood.
This is indeed the case. Even if the blood is flowing in the dissection and seems not to be lost, in fact, after this part of the blood flows into the dissection, there is less blood flowing in the true lumen of the blood vessel. The dissection is false, not a real blood vessel. It is not connected to the main blood vessels of the organ. Blood needs to go from the true cavity to the organ to provide nutrition to the organ. The blood that went to the dissection escaped and failed to reach the organs. This will cut off the blood flow to the blood vessel segment where the dissection occurs. As long as the main blood vessels supplying other organs are related to the dissected blood vessel, their blood supply will be cut off. These organs are naturally in a state of ischemia, which is medically called malperfusion or insufficient perfusion.
For example, if one or both renal arteries are affected, the patient may experience anuria and hematuria, or in severe cases, renal failure.
Involvement of the celiac artery may lead to irreversible consequences of hepatosplenic infarction.
If the lower limb arteries are affected, the symptoms may be mild, such as chills, or severe, such as pain and necrosis. This is why Yaxi's mother's limbs are cold.
If the spinal cord is cut off from blood flow, symptoms may appear in the corresponding spinal cord segment, ranging from lumbar pain to paraplegia.
The innominate artery and left common carotid artery mentioned above were "pinched", and central nervous system symptoms appeared.
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