Xiao Ran accurately judged and completely broke the deadlock!
Let the entire neurology department fall into ecstasy.
Director Su Wensheng took the lead and quickly sorted out Zhang Yu’s entire illness process.
In short, it is.
There is a blockage in the patient’s brain, resulting in cerebrospinal fluid cannot be replaced, and at the same time, new cerebrospinal fluid is still being generated, which will lead to an increase in intracranial pressure!
Increased intracranial pressure, compression of the corpus callosum, or other internal tissues!
This leads to myoclonus and night terrors!
Complete closed loop!
“Immediately arrange a radiosucleoside brain pool scintigraphy, check for brain blockage, and if it exists, place a shunt tube in one ventricle, and if it can be restored, there should be no big problem!” Remember to check the cerebrospinal fluid! ”
Xiao Ran said quickly.
Su Wensheng and others focused their heads and took action!
The surgical placement of the shunt allows the cerebrospinal fluid to flow out, and the intracranial pressure will naturally disappear.
If it goes well.
Then, Zhang Yu’s condition can be solved quickly.
Xiao Ran frowned slightly.
“How do I always feel that something is wrong…”
There was a strange feeling that filled his whole body, and even though he had solved the mystery, it still lingered.
“Forget it!”
Xiao Ran didn’t know why, shook his head slightly, and returned to the consultation room.
See a doctor.
Work.
Go home!
Received Su Wensheng’s notice and thanks.
The operation went very smoothly!
In the tone, there was a lot of gratitude, and he invited Xiao Ran to dinner.
After repeated remarks, there was another thank you.
Sleep with beauty.
……
……
Following.
Xiao Ran woke up from the bed.
Claim your rewards!
The system sound sounds.
The reward arrives!
And yet,
After seeing the reward in your account.
Xiao Ran’s face was suddenly stunned, his face quickly sank, and his heart was shocked.
Because,
He did not receive rewards above the intermediate level!!!
There is a problem!
Compared to the difficulty of diagnosis in the past.
Yesterday’s Zhang Yu’s diagnosis, even if it was not advanced.
It can definitely be classified as an intermediate difficulty.
This morning, however,
Xiao Ran did not receive an intermediate reward!
If it wasn’t a system error.
That must be that there is an error in my diagnosis.
Wrong!
Xiao Ran’s eyes condensed, and he immediately denied this idea.
His own diagnosis is completely correct, otherwise, Su Wensheng would never have called to report to him last night.
Then there is only one possibility left!
“The diagnosis is not over!”
Suddenly.
Xiao Ran’s pupils shrank.
“Rub! It seems that the curvature of the corpus callosum is not the ultimate cause! ”
Right at this time.
The phone rang.
Unfamiliar number!
Put through.
Su Wensheng’s impatient voice immediately spread!
“Doctor Xiao, are you awake?”
“Wake up, Director Su, what’s going on?”
Xiao Ran nodded slightly.
He knew that Su Wensheng must have come for Zhang Yu’s illness.
Sure enough.
“Doctor Xiao, something is wrong!”
Su Wensheng was a little distressed, thinning hair, and a few more strands fell out.
“Yesterday, you made the right judgment! The patient does have increased intracranial pressure, resulting in curvature of the corpus callosum. However, this is not the cause, but the symptom! ”
The cause is the root cause of everything else.
But the symptoms mean that there is a deeper reason behind the curvature of the corpus callosum.
“Yesterday, after I sent the cerebrospinal fluid for testing, the results came out this morning!”
Su Wensheng’s tone paused slightly.
Sighed: “Cerebrospinal fluid examination shows that oligoclonal band is positive!” Visual evoked potential examination shows a slowdown in brain functioning. Moreover, last night the patient had night terrors again and almost did not jump from the stairs. ”
(Oligoclonal band: under pathological immunity, certain clonal plasma cells can be abnormally proliferated, some immunoglobulins can be synthesized, and several separated, narrow, discontinuous bands are formed in the Y globulin region during electrophoresis.) Simply put, because of the immune system’s ability to exercise immunity, there will be bands. If it appears in the cerebrospinal fluid, it means that there is inflammation in the brain! Probably so. )
Finished!
Xiao Ran couldn’t help but scold secretly in his heart, a little sad.
The reason is simple.
When oligoclonal bands are detected in the cerebrospinal fluid, and visual evoked potential examination shows that brain function slows down.
There is almost a 95% chance that the patient has multiple sclerosis! (MS) (A common central nervous system demyelinating disease that causes symptoms such as limb paralysis, limb tremor, persistent vertigo, night terrors, etc.) )
Of course,
The remaining five percent possibility is viral encephalitis, neurosyphilis, AIDS…
And yet,
These diseases, which they had screened for in the first place, did not meet.
Even if it is not screened, it will not cause night terror symptoms!
At the same time,
This means that the patient’s predictable life expectancy will never exceed five years!
Moreover,
Be able to walk normally, up to two years!
I rub!
This kid is only 16 years old.
Fate.
Xiao Ran is not the king of heaven, there are too many lives and deaths, and he is not under his control!
“Is the MS lesion examined?”
After Xiao Ran was slightly silent, he asked softly.
For Xiao Ran’s question.
Su Wenshan was expected.
He knows
With Xiao Ran’s knowledge, he will definitely be able to judge at the first time that Zhang Yu has a high probability of suffering from MS.
“MRI did not detect lesions.”
There was a pause
Su Wensheng said sadly: “Dr. Xiao, you also know that the patient’s illness time is too short, no more than two weeks, but if you want to be diagnosed, it will take at least 6 months!” I guess he won’t last that time! ”
Zhang Yu’s condition is developing rapidly.
Against all odds.
and multiple sclerosis, some inconsistent.
Xiao Ran was slightly silent.
He had an answer in his head.
However, he did not dare to confirm!
Acute progressive multiple sclerosis!
Among the many types of MS, the most serious and terrifying one.
If that’s the case….
Whether Zhang Yu can last for a month is unknown.
After Xiao Ran was slightly silent.
Softly spoke: “First tell his father the diagnosis results, in addition, I want the medical history of his parents.” ”
Su Wensheng sighed lightly.
He knows.
Before seeing the lesion, Xiao Ran will never give up.
The rigor is outrageous.
His vicissitudes of his eyes showed a little emotion.
“Good! Wait a minute, I’ll send you! ”
Moment.
The information is in hand.
On the way back to the hospital, Xiao Ran quickly searched.
Moreover, after arriving at the hospital, his footsteps did not stop, and he went straight to Zhang Yu’s ward.
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