Recently, 13-year-old junior high school student Xiao Wu (pseudonym) suddenly had a severe headache during class, and after being taken home by his parents, his symptoms were relieved after gua sha massage. However, in the evening, he suddenly lost consciousness again and had two convulsions in his limbs.
The parents hurriedly sent him to the local hospital, and the cranial CT examination confirmed that the child had a cerebral hemorrhage, and there was a large hematoma in the left frontal lobe, which had rushed into the ventricles, and it was necessary to quickly do a craniotomy to relieve the hematoma's compression of brain tissue.
Subsequently, Xiao Wu was transferred to Huashan Hospital and Fujian Hospital of the National Regional Medical Center. When he arrived, Xiao Wu was in a coma. CTA (CT angiography) of the brain showed that his intracerebral hemorrhage was caused by a malformed arteriovenous rupture located posteriorly and medially to the hematoma.
Because such a preoperative examination cannot see the details in the brain, the patient's vascular malformation is complex, and if the operation is direct, it is likely to cause intraoperative hemorrhage. Lin Yuanxiang, director of the Department of Neurosurgery, and Wang Dengliang, deputy director, immediately organized experts from the department to discuss the surgical plan. In the end, in the compound operating room, they first intervened to embolize the deformed arteries and veins to reduce the risk of blood vessel re-rupture, and then performed microscopic deformity segment resection, vascular port suture, plus removal of hematoma, to save Xiao Wu. The operation lasted more than 10 hours. At present, Xiao Wu has been successfully discharged from the hospital.
According to Lin Yuanxiang, cerebral arteriovenous malformation rupture and hemorrhage is a kind of congenital cerebrovascular disease with a high incidence in clinical practice, which is most common in young people around 20 years old, with acute and severe onset, disability and high mortality rate. Arteriovenous malformation refers to a malformed vascular mass in which arteries and veins are mixed together, and the weak malformed blood vessel wall is easy to rupture and bleed due to arterial venousization and venous arterialization. Abnormal vascular development, genetic mutations, external environment, and acquired special injuries during the embryonic period may affect or lead to the occurrence of the above conditions.
He reminded that more than half of patients with cerebral arteriovenous malformations have a history of long-term headaches, often on one side, similar to migraines, which can be relieved on their own. If the patient has the above conditions and suddenly has severe headache, vomiting, seizures or even impaired consciousness, even if it is a young person, it is necessary to go to a major hospital for cranial CT and CTA examination in time to check for this disease. (Reporter Zhu Danhua Correspondent Guo Lijuan).