What did the junior sister mean? Huang Zhilei's mind was spinning again and again, and he found that his mind was likely to be twisted into a knot by the junior sister in a short period of time. Before long, sweat dripped down his forehead, and he asked, "Yingying, why did you ask that patient to do an MRI before?"
This is the problem she mentioned early in the morning.
Senior Brother Huang should have realized it by now, why would he continue to ask questions?
For example, Dr. Song had probably foreseen it and asked her if she had decided on 7.2. Senior Brother Cao readily agreed to use a ventriculoscope, and had been prepared for it.
Could it be that Senior Brother Huang didn't notice it before?
Huang Zhilei realized that he was the last one to notice it only after he asked the question.
It is true that she mentioned the MRI to give a disclaimer to the patient's family. However, given her ability, it is impossible for her to deliberately mention such a disclaimer for no reason. It can only be that she predicted that the patient's condition really needed further MRI diagnosis.
First of all, it must be affirmed that the existing examinations have confirmed that the patient does not have space-occupying obstruction, and Dr. Jin and his colleagues' diagnosis of communicating hydrocephalus is well-founded and basically correct.
It is not wrong to suggest that patients should first undergo medical treatment and then transfer to surgery for shunt surgery if the medical treatment is ineffective. After all, for communicating hydrocephalus, medical treatment and shunt surgery are generally the best treatments. There are always accidents. Some special cases of communicating hydrocephalus can use other surgical methods to avoid the subsequent risks and pain brought to patients by long-term shunt placement.
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This surgical method is the endoscopic third ventriculostomy (ETV) mentioned earlier.
Unfortunately, after explaining this to Dr. Jin, Dr. Jin communicated with the patient's family. Because the cost of two MRI examinations was too expensive, the patient's family refused to let the patient do it, and wanted to spend the only money on treatment. The doctor could only try to find a solution for the patient.
Can a ventriculoscope be used to detect problems with a patient’s ventricles?
Can we help patients avoid shunt surgery and instead do ETV?
Xie Wanying had never used a ventriculoscope before, so she certainly didn't have the confidence before the operation. She could only plan and try it based on the principles of ventriculoscope she had read in academic journals.
Now that the ventriculoscope is actually being used, it is expected to be feasible according to the plan she had simulated before the operation, so I am sharing it with you.
After understanding her initial idea, Huang Zhilei broke out in sweat again.
Mainly, the magnetic resonance imaging she mentioned, magnetic resonance phase contrast cine imaging, can accurately measure the cerebrospinal fluid flow velocity in a specified area, and on this basis establish a flow curve diagram (flow velocity-time curve diagram).
One of the focuses of the scan was the area where she suspected there was a problem, the cerebral aqueduct, which she was currently scanning with a ventriculoscope.
The cerebrospinal fluid flow rate in this area can indeed provide evidence for distinguishing between communicating hydrocephalus and obstructive hydrocephalus, or it is the key point to support whether the doctor can perform ETV surgery on the patient.
If there is a problem with the flow rate of the cerebral aqueduct, it is likely that the cerebral aqueduct is trumpet-shaped. This shape of the cerebral aqueduct is similar to obstructive hydrocephalus, and ETV can be tried.
The problem was that the young surgeon had a "crazy idea" and thought that she could use the ventriculoscope to visually detect that the abnormal cerebrospinal fluid flow rate here was exactly within the range of the trumpet-shaped cerebral aqueduct.
Huang Zhilei really couldn't see or figure it out, even with experience, he could only sweat over it.
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