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Anonymous users2024-02-15For acute liver failure (ALF) where intracranial hypertension (ICP) is not controlled, moderate hypothermia** is effective in reducing intracranial pressure, thereby giving them the opportunity for orthotopic liver transplantation (OLT).
Dr Rajiv Jalan, of the London Medical School of University College in the United Kingdom, said that about 20% of patients with acute liver failure (ALF) die from elevated intracranial pressure (ICP) while awaiting liver transplantation. To this end, the researchers investigated the clinical efficacy of hypothermia in patients with intracranial hypertension ALF who did not respond to standard internal medicine.
The researchers selected 14 patients with ALF who had elevated ICP and were waiting for orthotopic liver transplantation after standard internal medicine**. They used a cooling blanket to bring the patient's body temperature down to 32 -33. It was found that 13 patients were cooled for an average of 32 hours (range:
10-118 hours). and can successfully receive OLT, with no significant cooling-related complications before and after OLT, and complete neurological**.
The investigators noted that the ICP before cooling was mmHg, which decreased to mmHg at hour 4 and remained until hour 24 (mmHg) (p < Moreover, the mean arterial pressure and cerebral perfusion pressure were significantly increased, and the need for inotropes was significantly reduced.
In addition, low temperature caused a continuous and significant decrease in arterial blood ammonia concentration, brain metabolism, cerebral blood flow, brain cytokine production, and oxidative stress markers.
According to Dr. Jalan, moderate hypothermia** is effective in reducing intracranial pressure in patients with acute liver failure (ALF) who are not controlled by intracranial hypertension (ICP). He suggested a large, multicenter trial using cryogenic ALF.
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Anonymous users2024-02-14Moderate hypothermia** is effective in reducing intracranial pressure, giving them the opportunity for orthotopic liver transplantation (OLT).
That's the principle.
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Anonymous users2024-02-13Hypothermia**: It is a method of physically reducing the patient's body temperature to the desired level to achieve the purpose of the disease. According to the different temperatures, it is divided into deep low temperature, low temperature, sub-low temperature, etc.
Sub-hypothermia is one of the methods of neurological diseases, and the conditions for its use are ripe. In stroke, systemic or local body surface cooling and moderate hypothermia are more commonly used, and our department has carried out clinical application studies such as large-scale cerebral infarction hypothermia**, hypothermia combined with microinvasive intracranial hematoma puncture, hypertensive intracerebral hemorrhage and hypothermia combined with continuous intravenous nimotong, severe subarachnoid hemorrhage, etc. Patients with clinical encephalitis, hyperthermia, coma, and central hyperthermia can be treated with hypothermia**, which is expected to improve the prognosis and clinical efficacy.
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Anonymous users2024-02-12Hypothermia is a method of physically lowering a patient's body temperature to an expected level to achieve the purpose of the disease.
In recent years, foreign countries have taken the lead in using hypothermia (30-35)** patients with cerebral ischemia, cerebral hypoxia and cerebral hemorrhage, and have achieved remarkable research results.
The application and research of clinical cryohypothermia has been widely used in cardiac surgery and neurosurgery, and has achieved good brain protection, but when the body temperature is lower than 28, it often induces serious complications such as arrhythmia and coagulation mechanism disorders. Therefore, since the 80s, cryogenic has been rarely used, and at the end of the 80s, studies have found that the drop in brain temperature 2 3 (hypothermia) also has a protective effect on ischemic brain injury, and there are no complications caused by hypothermia, so that low temperature ** has regained people's interest. In recent years, foreign countries have taken the lead in using hypothermia (30-35)** cerebral ischemia, cerebral hypoxia and cerebral hemorrhage patients, and have achieved remarkable research results, in 1996, METZ used ice blankets to cool down the body surface of a group of patients with severe head trauma, and the results showed that 7 out of 10 cases returned to the normal state before the injury, and it was believed that low temperature (can reduce intracranial pressure; In the same year, REITH's clinical observation of 390 stroke patients found that timely lowering of body temperature after stroke can help reduce the mortality rate.
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Anonymous users2024-02-11There is a certain reason for the occurrence of brain herniation, so in daily life, we must pay attention to avoid the ** that causes brain herniation, such as encephalitis, to avoid these infections; For stroke, we need to prevent high-risk factors such as blood pressure, blood sugar, blood lipids, blood inflammation and other high-risk factors that cause stroke. Reducing the primary cause of brain herniation is the most important thing we should pay attention to in our daily life. Of course, there are some traffic accidents, trauma, so we have to avoid damage to the head as much as possible.
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Anonymous users2024-02-10**It is very important, if we are divided into two parts, one part of our surgery is good, the second part is **, Chengdu Gu Lian suggested, postoperative or actively do ****.
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Anonymous users2024-02-09The underlying mechanism of brainstem hemorrhage is secondary to vascular injury, most commonly hypertension. Hemorrhage causes severe destruction of the brainstem, often with a severe prognosis. Young people may experience bleeding in the absence of high blood pressure.
These lesions are usually secondary to vascular malformations. Hematomas are usually small, producing milder defects. In many patients with this vascular lesion, surgical removal of the hematoma may lead to early improvement.
Surgical excision can prevent**. Minor bleeding may be secondary to lacunar disease (type II lacuna). The clinical presentation of these patients resembles that of ischemic lacunar involvement of the brainstem.
Brainstem hemorrhage, in order of frequency, in the pons, midbrain, and medulla.
The survival rate depends on the amount of bleeding, generally within 5ml will have a higher survival rate, and the mortality rate is very large if the bleeding volume is higher than 10ml. And the brainstem position is not something that anyone can do, and everyone dares to do it, as far as I know, Professor Bartlangfi of Germany has many cases in the field of brainstem surgery.
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Anonymous users2024-02-08First of all, I would like to express my sympathy and comfort.
This is normal.
Softening means necrosis.
Even if you can survive.
Serious sequelae are also inevitable.
Basically, they are paralyzed in bed or in a vegetative state.
No doubt about it!! How did the patient get before? Western Surgery? >>>More
Increased intracranial pressure is mainly due to poor drainage of cerebrospinal fluid or intracranial space-occupying lesions, which are mainly harmful to compress brain tissue and even cause brain tissue displacement that is brain herniation. Elevated intracranial pressure due to cerebral thrombosis or stroke occurs mainly in older patients with a history of atherosclerosis and is acutely onset. Further testing is recommended to see if the cerebrospinal fluid is draining smoothly.
FYI: The current mainstream methods of intracranial aneurysm are divided into two types, one is craniotomy, clipping the aneurysm; The second is interventional surgery, the use of spring coils for endovascular embolization, the cost of the two types of surgery comparison, the operation is definitely cheaper, an aneurysm clip is about 3000-4000 yuan, under normal circumstances, if it is an aneurysm, the use will not exceed 3 aneurysm clips, so plus the cost of surgery and anesthesia, the cost of this operation can be controlled within 20,000 yuan, but because it is a craniotomy, the risk is relatively large, and it is more suitable for aneurysms in superficial areas that are easy to operate; The interventional surgery, in fact, is the same as your aunt's DSA, but also from the femoral artery catheterization, the difference is that the former is only imaging, and the operation is through this catheter to insert the metal spring coil, which plays the role of blocking the aneurysm, the cost is very high, generally a spring coil is thousands to tens of thousands of yuan, and an aneurysm, especially a wide-neck aneurysm, sometimes requires more than a dozen or even twenty spring coils, so it is impossible to get down without hundreds of thousands, but the advantage is that the risk is small, and the postoperative recovery is fast. For aneurysms that are difficult to operate with deep surgery, interventional surgery has its advantages.
This is due to diet, work and rest, physical, genetic, and work. So when this happens to us, we must go to the hospital**.
Naturally, the sooner the better, and the direct cause of death of acute intracranial hypertension is brain herniation. As long as the early intracranial pressure is properly controlled, the chance of brain herniation can be greatly reduced. The more dehydrated** you are, the worse the effect will be.