herniation crisis
Introduction
Introduction When there is a space-occupying lesion in a certain cavity in the cranial cavity, the pressure of the sub-chamber is higher than that of the adjacent sub-chamber, and the brain tissue is displaced from the high-pressure area to the low-pressure area, thereby causing a series of clinical syndromes called cerebral palsy. . Any large volume of space-occupying lesions in the brain can cause cerebral palsy when the pressure distribution in the cranial cavity is uneven. The lesions on the screen cause the cerebellar incision, and the lesions in the lower part cause the occipital foramen. Clinicians should be avoided due to cerebral palsy caused by iatrogenic factors.
Cause
Cause
Common lesions that cause cerebral palsy are:
1. Various intracranial hematoma caused by injury, such as acute epidural hematoma, subdural hematoma, intracerebral hematoma, etc.
2. Various intracranial tumors, especially tumors located in one side of the cerebral hemisphere and tumors of the posterior cranial fossa.
3. Intracranial abscess.
4. Intracranial parasitic diseases and various other chronic granulomas. On the basis of the above-mentioned lesions, if some artificial factors are added, for example, excessive cerebrospinal fluid is released for lumbar puncture, so that the pressure difference between the cranial cavity and the spinal canal, the supratentorial cavity and the subdivision sub-cavity increases, which may promote Formation of cerebral palsy.
Examine
an examination
Related inspection
Brain CT examination brain MRI examination EEG examination brain nerve examination
First, the cerebellum incision
1. Symptoms of increased intracranial pressure: manifested as severe headache and frequent vomiting, the degree is more intensified than before the cerebral palsy, and there is irritability.
2. Change of consciousness: manifested as lethargy, shallow coma and even coma, and the response to external stimuli is slow or disappears.
3. Pupil changes: the pupils on both sides are not equal. At the beginning, the pupils on the disease side are slightly reduced, the light reaction is slightly dull, and the pupils on the disease side gradually become larger and slightly irregular. The direct and indirect photoreaction disappears, but the contralateral pupils still disappear. It can be normal, because the affected oculomotor nerve is compressed and pulled. In addition, the affected side may also have a risk drooping, an eccentricity of the eyeball, and the like. If the cerebral palsy continues to develop, bilateral dilated pupils may appear, and the photoreaction disappears. This is the function of the dysfunction of the oculomotor nucleus in the brainstem.
4. Movement disorders: Most occur on the opposite side of the dilated side of the pupil, showing that the voluntary activity of the limb is reduced or disappeared. The continued development of cerebral palsy causes the symptoms to spread to both sides, causing muscle weakness in the limbs or intermittent head and neck recoil, limbs straight, over-extension of the back, angulation, and is called brain tonic, is the brain stem Characteristic manifestations of severe damage.
5. Disorders of vital signs: manifested as changes in blood pressure, pulse, respiration, and body temperature. In severe cases, the blood pressure is high and low, the breathing is fast and slow, sometimes the face is flushed, sweating, sometimes turning pale, sweaty, body temperature can be as high as 41 ° C or higher, but can be as low as 35 ° C or less, and finally breathe. Stop, finally blood pressure drops, heart arrest and death.
Second, the occipital large hole sputum: patients often only have severe headache, repeated vomiting, vital signs disorder and neck stiffness, pain, consciousness changes appear later, no pupil changes and respiratory arrest occurs earlier.
Third, the cerebral palsy: caused by the softening and necrosis of the brain tissue of the cerebral hemisphere in the diseased side of the diseased side, symptoms of paralysis of the contralateral lower extremity, dysuria and other symptoms.
Diagnosis
Differential diagnosis
Cerebral palsy: When there is a space-occupying lesion in a certain cavity in the cranial cavity, the pressure of the sub-chamber is higher than that of the adjacent sub-chamber, and the brain tissue is displaced from the high-pressure area to the low-pressure area, thereby causing a series of clinical syndromes. For the brain. The brain tissue on the screen (the hippocampus of the temporal lobe, hook back) is squeezed under the curtain through the cerebellum, known as the cerebellum or the scorpion. Under the curtain, the cerebellar tonsils and the medulla oblongata are squeezed into the spinal canal, called the occipital foramen or cerebellar tonsil. The cingulate of one side of the cerebral hemisphere is pushed back into the contralateral cavity through the inferior sac, called the cerebral palsy or the cingulate palpebral.
