dull eyes
Introduction
Introduction The stagnation of the eyes means that due to various reasons, congenital diseases or acquired brain diseases cause the eyes to be dull, inflexible, and slow to respond to external stimuli, showing a dull appearance. This can happen when you are distracted or when you receive a major blow. Congenital diseases: such as chromosomal abnormalities, hereditary metabolic disorders, brain malformations and congenital hydrocephalus, can cause this symptom. Hydrocephalus due to congenital dysplasia of brain tissue is called congenital hydrocephalus. The cause of hydrocephalus may be an imbalance between the secretion and absorption of cerebrospinal fluid, that is, excessive or malabsorption of cerebrospinal fluid.
Cause
Cause
1. Congenital diseases: such as chromosomal abnormalities, hereditary metabolic disorders, brain malformations and congenital hydrocephalus.
2. Trauma: Traumatic brain injury is a common cause of symptomatic epilepsy in infancy. Contusion, hemorrhage, and ischemia can also cause local brain tissue to soften and become epileptic foci in the future. About 5% of adults have epilepsy after closed brain injury, and more epilepsy occurs in severe and open brain trauma, up to 30%.
3. Infection: In the acute phase of various encephalitis, meningitis, brain abscess, congestion, edema, the effects of toxins and exudates in the blood can cause seizures, scars and adhesions formed after healing may also become epileptic foci Parasites such as cerebral schistosomiasis and cerebral cysticercosis often cause epilepsy.
4. Poisoning: lead, mercury, carbon monoxide, ethanol and other poisoning, as well as systemic diseases such as hepatic encephalopathy, hypertension syndrome, acute nephritis, uremia, etc., can cause seizures.
5. Intracranial tumors: In patients with epilepsy after 30 years of age, in addition to brain trauma, brain tumors are a common cause, especially slow-growing gliomas, meningiomas, and astrocytomas.
6. Cerebrovascular disease: In addition to vascular malformation, seizures are milder, cerebrovascular disease epilepsy is more common in middle and old age. Hemorrhagic and ischemic cerebrovascular disease can cause epilepsy. About 5% of epilepsy begins to occur about 1 year after the illness.
7. Nutritional metabolic diseases: hypoglycemia, diabetic coma, hyperthyroidism, vitamin B6 deficiency, etc. can cause seizures.
8. Degenerative diseases: Seizures such as tuberous sclerosis and Alzheimer's disease are also common.
9. Febrile seizures: severe or frequent febrile seizures in children are prone to cause local brain hypoxia or edema, and later form epileptic foci and cause disease.
Examine
an examination
Related inspection
Cranial nerve examination, nervous system examination, oculomotor examination
(1) CT scan of the head: CT examination is the first choice for clinical suspected cerebral hemorrhage, which can show a round or oval uniform high-density hematoma. After the onset, a fresh hematoma with clear boundary can be displayed, and the location, size and shape of the hematoma can be determined. And whether it breaks into the ventricles, edema around the hematoma and mass effect, such as a large amount of blood in the ventricle can be seen in high-density cast, ventricle dilatation, ring enlargement around the hematoma after 1 week, the hematoma becomes low density or cystic after absorption Changes, CT dynamic observation can be found in the pathological evolution of cerebral hemorrhage, and the first time to guide clinical treatment in the course of disease changes during the course of disease treatment. At present, head CT has become a more extensive method of examination.
(2) MRI examination: can find a small amount of brain stem or cerebellar hemorrhage that can not be determined by CT, can distinguish the cerebral hemorrhage that CT can not recognize after 4 to 5 weeks of disease, distinguish old cerebral hemorrhage and cerebral infarction, and show the phenomenon of vascular malformation Can also roughly determine the bleeding time, whether repeated bleeding, etc., but the MR examination requires the patient to stay in the scanner for a long time (more than 10 minutes), which is difficult for patients with existing disturbances, generally less than CT examinations are widely used.
(3) DSA whole cerebral angiography: cerebral angiography used to be the main diagnostic tool for cerebral hemorrhage, because it can not show the hematoma itself, only the location and size of the hematoma can be estimated according to the displacement of the relevant blood vessels around the hematoma, and DSA The inspection was an invasive examination and the current first-line application has been significantly reduced. It is worth mentioning that DSA is still significant in the identification of the causes of cerebral hemorrhage, because it can visually see the shape and shape of cerebral vessels. Patients suspected of having cerebral vascular malformations or aneurysm rupture should need DSA examination. Clear diagnosis.
(4) cerebrospinal fluid examination: cerebral hemorrhage diagnosis is generally not done cerebrospinal fluid examination to prevent cerebral palsy, but in the unconditional brain CT scan or brain MRI examination, lumbar puncture still has a certain diagnostic value. After cerebral hemorrhage, due to brain tissue edema, intracranial pressure is generally high. 80% of patients have bloody cerebrospinal fluid after 6 hours of onset, because the blood can break from the brain parenchyma into the ventricle or subarachnoid space, so the cerebrospinal fluid is mostly bloody or yellow. A small number of cerebrospinal fluids are clear. Therefore, when the lumbar puncture cerebrospinal fluid is clear, the possibility of cerebral hemorrhage cannot be completely ruled out. The dehydrating agent should be used to reduce intracranial pressure before surgery. If there is an increase in intracranial pressure or cerebral palsy, it should be contraindicated.
Diagnosis
Differential diagnosis
Tuberculous meningitis is the most important type of tuberculosis in children. It usually occurs within 3 months to 1 year after the original tuberculosis infection, and is more common in children 1 to 3 years old. The course of tuberculous meningitis from onset to death is about 3 to 6 weeks, which is the most important cause of tuberculosis death in children. Before the advent of anti-tuberculosis drugs, the mortality rate was almost 100%. Patients with hypokalemia have the following clinical manifestations:
1. The limbs are weak and weak, soft sputum, sputum reflexes are slow or disappear, and severe cases have difficulty breathing.
2. Apathy, gaze, lethargy, unconsciousness.
3. Nausea, vomiting, bloating, intestinal paralysis.
4. Heart palpitations, arrhythmia.
Patients with hypokalemia have the following clinical manifestations:
1. The limbs are weak and weak, soft sputum, sputum reflexes are slow or disappear, and severe cases have difficulty breathing.
2. Apathy, gaze, lethargy, unconsciousness.
3. Nausea, vomiting, bloating, intestinal paralysis.
4. Heart palpitations, arrhythmia.
