Chapter 285: Brain hernia compressing the brain stem, life hanging by a thread, who can save it? !

Induce coma again.

Lower body temperature.

Then, send for preoperative preparation.

Routine examinations were done before, and there were reports on cerebrospinal fluid and biochemistry. Only an additional MRI was needed.

After the emergency MRI came out, the urgency of the operation was increased again!

Xu Qiu's expression was solemn when he saw the results.

Head MRI showed that part of Luo Di's cerebellum had been squeezed into the foramen magnum, which could compress the life center of the brainstem at any time and cause death!

This also means that the patient's life is hanging by a thread.

"Give broad-spectrum antibiotics immediately."

"Go on stage in one hour!"

Xu Qiu immediately made adjustments and moved the operation three hours later forward again.

...

Under the bright shadowless lights, doctors in dark green surgical gowns filed in and stood in their respective positions.

"Director Lin!"

"Director Jin!"

Wang Fan, Yun Mei and others who were observing the operation greeted the two directors of neurosurgery.

Unexpectedly, even Director Lin and Deputy Director Jin Yucheng came.

"Have you given intravenous antibiotics half an hour before the operation?" Director Lin asked.

"Dr. Xu specifically instructed that the dosage has been overdosed." The anesthesiologist replied.

"That's good..."

Director Lin and Jin Yucheng looked at each other, both very solemn.

Intraventricular shunt is actually not that difficult.

Since Xu Qiu opened up the training base for craniocerebral separation in neurosurgery, the comprehensive level of neurosurgeons in the hospital has improved significantly.

Jin Yucheng is young and smart, learns very quickly, and is quite talented in high-tech neurosurgery.

He was so far ahead that he became the most qualified doctor in Linhai First Hospital to challenge the real craniocerebral separation after Xu Qiu.

Nowadays, any doctor in neurosurgery can easily get the ventricular shunt.

But at the moment, I'm afraid that no one dares to do Luo Di's operation except Jin Yucheng, Director Lin and a few other neurosurgery experts.

Because the brain herniation has entered the foramen magnum!

At this time, let alone craniotomy, even the change of body position and the use of anesthetic drugs may become the last straw that breaks Luo Di's back.

"Here it comes!"

At this moment, everyone looked at the door of the operating room at the same time.

Swish——

As the airtight door was stepped open, Xu Qiu walked in, and the circulating nurse immediately helped put on the surgical gown.

When Xu Qiu stood at the main operating position, with the shadowless light on, everyone suddenly felt a sense of security.

Director Lin, Director Jin and others all felt incredible.

The danger of this operation is self-evident.

It can be said that no one can guarantee that Luo Di can step down safely.

Even, who dares to say that there is a 30% probability, it is enough to walk sideways in the field of neurosurgery.

However, when Xu Qiu stood in front of the stage, they suddenly breathed a sigh of relief...

It turned out that, unknowingly, they had already regarded Xu Qiu as the last guarantee of the entire neurosurgery from the bottom of their hearts.

...

"The operation begins."

Xu Qiu's calm voice resounded throughout the operating room.

Everyone in the room moved in an instant.

Endotracheal intubation.

General anesthesia.

There are also various rescue drugs and preparations for intraoperative infusion of drugs...

After the anesthesia was completed, Xu Qiu also picked up the scalpel at the same time.

Ventricular shunt surgery is not difficult.

First puncture, then drill the skull, then place a tube in the puncture channel and the ventricle, and finally make a subcutaneous tunnel to drain the excess cerebrospinal fluid and water accumulation, and it can be completed.

The difficulty is the precision of the hands.

If the movement is a little bigger, the brain will be squeezed into the foramen magnum a little more, and Luo Di will be finished.

"Are you sure you want to puncture the foramen magnum?" Director Lin was frightened.

There are many options for puncture sites.

For example, next to the midline of the temporal region, enter from the center of the pupil.

Or the triangular area at the back top, about 2.5~3cm above the auricle.

No matter which one, the risk is definitely lower than the occipital region.

That place is close to the foramen magnum and is also the most likely place for accidents.

But if it succeeds, it can also immediately relieve the crisis of brain herniation, so that the next operation will not be so daunting.

"Just the foramen magnum." Xu Qiu did not hesitate.

Other approaches are too slow.

Wait for puncture and then drilling, and finally make a subcutaneous tunnel to drain cerebrospinal fluid... Luo Di can't hold on for that long!

What he has to do now is to take risks and use his personal ability to fight for a chance for Luo Di to have an operation.

As long as Xu Qiu does not make mistakes and controls the entire puncture and drilling process, this operation is basically half successful.

Beep beep--

In the operating room, the prompts of various monitoring instruments are the eternal background sound.

"Let's start."

After making a decision, Xu Qiu no longer hesitated and made a small horseshoe-shaped incision six centimeters from the external occipital protuberance.

Then, cut the dura mater.

In the bright surgical field, everyone can clearly see that there are many blood clots around the incisions under the patient's dura mater and the cerebral cortex.

Remove the blood clots and continue down.

Gurgle--

Dark grey, slightly viscous liquid spurted out from the opening of the cortex.

This was the intracavitary fluid left by the infection.

After the liquid was absorbed, this part of the brain tissue collapsed.

Director Lin and others felt depressed.

No one knew whether this brain area was functionally active.

Would its collapse cause Luo Di to lose some function, or even to fall asleep and never wake up?

However, Xu Qiu only glanced at it and continued the operation.

"Metal core guide." He said without raising his head.

Director Lin immediately handed over the instrument that had been determined before the operation.

"Monitor vital signs at any time."

Xu Qiu reminded the anesthesiologist, and then punctured the needle from the center of the forehead of the ventricle, two centimeters above the eyebrows.

At this moment, everyone's heart was in their throat.

Fearing that the patient's breathing and heartbeat would stop in the next moment!

But this scene did not happen.

Under the shadowless lamp, Xu Qiu's hand was very steady, without a trace of tremor.

After he slowly inserted the brain needle with the core guide five centimeters, he suddenly felt a slight change in the pushing feeling on his hand.

"It's here."

Xu Qiu made a judgment immediately.

He pulled out the metal core guide, and saw cerebrospinal fluid flowing out of the core guide instantly.

This confirmed that the brain needle had indeed entered the ventricle.

"Neuroendoscopic assistance."

The next step is the most important part of the puncture.

After entering the ventricle, the remaining part of the puncture needle needs to be inserted.

At this time, the catheter can easily enter the choroid plexus. Once it is stuck near the temporal horn, the catheter will be blocked.

This is why the occipital puncture is very dangerous.

Its operation requirements are the highest among several parts.

However, this still did not stump Xu Qiu.

With the help of the neuroendoscope, Xu Qiu pushed and turned, and after a few back and forths, the catheter was fully inserted.

Just as he was about to connect the reservoir, Director Lin's face suddenly changed.