The 10 -year -old boy suddenly had a headache after going to the toilet, but it was cerebral hemorrhage!Doctor reminds: Time to see these situations in time

Recently, the five -year -old 10 -year -old teenager who had had a sudden headache and gradually fell into a conscious 10 -year -old. The emergency CT showed that it turned out to be a small brain intravenous deformity rupture and bleeding. MDT teams such as neurosurgery, emergency department, pediatrics, clinical nutrition, and rehabilitation medical departments such as the Municipal Fifth Hospital have worked together to make the young Di (a pseudonym) in danger. According to reports, adolescent brain bleeding is rare.

▲ Children Xiaodi

Xiaodi (pseudonym), who lives in Wenjiang, Chengdu, is 10 years old. He is a lively and cute little boy who likes to play football. At noon on September 12, Xiaodi suddenly felt uncomfortable after going to the toilet. Dad thought that Xiaodi was not suitable for eating, and it would be fine for a while, so he didn't care too much. Unexpectedly, Xiaodi just shouted his headache and uncomfortable a few minutes later. He quickly passed out. Dad found that the situation was wrong, and immediately sent Xiaodi to the emergency pediatric department of the Fifth Hospital of the Municipal Hospital.

The head CT examination prompts the small cerebral bleeding on the right side. Emergency pediatrics immediately asked for neurosurgery emergency consultation. The attending physician Ma Dongbin rushed to the scene to check the body and report the situation to the department. The emergency CTA examination further proves the cause of cerebral hemorrhage. After seeing Xiaodi's CTA, Deputy Chief Physician Liu Jia found that the child's right cerebral hemisphere has congenital cerebral vascular intravenous deformities. The cause of cerebral hemorrhage is that these abnormal blood vessels rupture and bleeding.

▲ CT image after surgery

The situation was urgent, and Deputy Chief Physician Liu Jia immediately organized a general discussion. After obtaining the consent of Xiaodi's parents, he decided to arrange surgery for him. From emergency pediatrics to neurosurgery, to anesthesia surgery centers and pediatrics, medical staff quickly set up a life channel for Xiaodi.

In the surgical room, the neurosurgeon surgery team fully reduces unnecessary bleeding, protects naive and delicate brain tissues, lasted more than 4 hours, smoothly removed the internal hematoma of Xiaodi and removed the deformity blood vessels. PICU (pediatric severe care room) was closely monitored, and had difficulty in delaying bleeding, cerebral edema, and infection.

Under the careful care of medical staff such as clinical nutrition and rehabilitation medical department, Xiaodi's limbs gradually returned to normal activities, and they could communicate and write normally.

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What is cerebral intravenous deformity? How to treat it?

According to neurosurgery of the Fifth People's Hospital of Chengdu, Brain Artiovenous Malformation (BAVM), also known as intracranial intravenous deformity, refers to the vascular malformations between the abnormal connection between the cerebral arterial system and the venous system. In the lesion site, the lack of capillaries between the cerebral artery and cerebral vein, causing the arteries to communicate directly with the vein, forming a short circuit between dynamic veins, causing a series of disorders of cerebral blood mobility. This is like short -circuit occurred directly with the ground line after the current starts from the fire.

Bleeding is the most common first manifestation of children's cerebral venous deformities. About 70 % ~ 80 % of children get sick with bleeding, followed by about 10 % to 15 % of epilepsy. Other symptoms include headache, physical weakness numbness, etc., less than 10 % of less than 10 % Children are accidentally discovered. Children's cerebral intravenous deformities are easier to cause bleeding than adults. Often bleeding is large. For the first time, about 1/5 of children with bleeding can be killed by bleeding, and the mortality rate of bleeding will further increase.

The identification of early symptoms of cerebral intravenous deformity is particularly important, which is conducive to the golden window period for rescue. The main ways of treatment include: craniotomy cutting, intervention of embolism and gamma knife radiation therapy. The specific treatment method should be determined according to the comprehensive analysis of the size, location, and children's own situation of vascular malformations.

Warm reminder: Here, neurosurgery reminds the majority of their families that if children suddenly have vomiting and physical weakness, they must go to the hospital in time. Children, especially young children, have poor expression skills. If they have symptoms of frequent crying and staring, it is best to go to the hospital for a head examination to avoid missing the best treatment time and cause serious consequences.

Red Star News reporter Wang Tuo

Edit Chen Yixi

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