Sun Lien was a little nervous, this nervous feeling had not appeared for a long time.

He even complained a little in his heart about the status bar - why are you showing a "Horner syndrome"? Isn't this misleading yourself into thinking about other diseases?

Horner syndrome is primarily a sign of neurological disorders, but vascular problems can also contribute to this set of symptoms. The reason why Sun Lien muttered in his heart was also very simple - he was worried that Wang Li had vertebral artery dissection.

Theoretically, it is possible for all the arteries above and below the human body to have arterial dissection. However, it is aortic dissection that is most common and most likely to cause severe symptoms.

Unlike other arteries, the aorta is much more pressurized than the other arteries. The high-pressure blood that has just been pumped out by the heart needs to be guided by the aorta, rotated 180 degrees through the aortic arch, and then enter other blood vessels, becoming the main source of power to drive all cells.

Because it has to be turned 180 degrees in the aortic arch, the pressure on the aorta in this area is the largest of all the arteries in the body. Once the human body has blood vessel wall damage due to various reasons, this blood vessel wall damage will be aggravated by the impact of high-pressure blood flow. If blood is poured into the hole, the lining and media of the arteries are constantly peeled apart – the end result is that the lining is unable to withstand the pressure and ruptures.

Aortic dissection has an extremely high mortality rate, with 90% of patients dying within 48 hours of onset without surgery.

From this point of view, Wang Li is undoubtedly the extremely lucky one. Her arterial dissection occurred in the vertebral artery, which was less stressed, rather than in the aorta. Otherwise, with the efficiency of her delaying three days to see a doctor, she would have died at her workstation yesterday.

Sun Lien put down the phone in his hand and rushed to the rescue room non-stop. Wang Li hadn't arrived yet, and he needed to do something to buy some time for Wang Li to come out - no one knew how serious Wang Li's vertebral artery dissection was, and as a disease that progressed very irregularly and often deteriorated explosively, arterial dissection should undoubtedly be one of the top priorities in the emergency room.

Sun Lien first found Cao Yanhua, the doctor in charge of the chest pain center of the emergency department of the Fourth Hospital. "Brother Cao, I want to ask you something......" He dragged Dr. Cao Yanhua out of his hot meal, "I have a patient here......

"I've just eaten...... Dr. Cao Yanhua protested weakly, "can't you let me listen to you while eating?"

"It's urgent, you wait a bit. Sun Lien didn't feel guilty about interrupting his colleague's meal at all, and he didn't care about worrying about this kind of thing now. "I've got a patient here, probably a vertebral artery dissection. ”

"Vertebral artery dissection?" Cao Yanhua suddenly forgot about the hot meal he had just arrived, "He just massaged his neck?"

"Uh...... Huh?" Sun was not familiar with the cause of vertebral artery dissection, so he didn't immediately understand what Dr. Cao was talking about. "It's not...... She had a sudden neck ache after a strenuous exercise......"

Cao Yanhua frowned and listened to Sun Lien's description, "Therefore, the main evidence that is showing up now is progressive pain and limited mobility, and CT shows right vertebral artery stenosis." He was silent for a moment and then nodded, "Got it, I'll arrange for intervention now, and when the patient arrives, you can stabilize the person first - it's better to do a B-ultrasound to confirm." Also, contact the family as soon as possible. Interventional procedures require a family member's signature. ”

Dr. Cao Yanhua is definitely the well-informed one in the emergency department. He quickly ran around the emergency room again and again, and began to arrange the group of participants in this operation. The vascular surgery and interventional departments may need to meet together and they have to decide together whether the surgery will be done with interventional treatment or through vascular surgery. At the same time, it is also necessary to have the stroke center take over as soon as possible and start monitoring the patient's vital signs - vertebral artery dissection is considered to be the scope of the stroke center.

Before that, Sun Lien first needed to obtain a conclusive evidence that could prove that Wang Li suffered from vertebral artery dissection.

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"What mezzanine?" Wang Li, who was lying on the hospital bed, was a little dazed, she looked at Sun Lien, and repeated in confusion, "What is a mezzanine?"

Sun Lien could only briefly explain what arterial dissection is, and said seriously, "You call your family right now, this disease has to be operated on immediately." If the mezzanine suddenly breaks, no one can save you. ”

Vertebral artery dissection is a little more dangerous than arterial dissection elsewhere – of course, unlike aortic dissection, which is largely hopeless after rupture. The mortality rate of vertebral artery dissection rupture is slightly lower.

However, vertebral artery dissection has a serious sequelae or side effect, which can lead to ischemic stroke.

Spontaneous vertebral artery dissection and carotid artery dissection are one of the leading causes of ischemic stroke in young and middle-aged adults. Although the incidence of spontaneous vertebral artery dissection in the population is about 1 in 100,000 per year, it is the cause of ischemic stroke in 10%~25% of young and middle-aged patients.

"The disease may soon progress again. Sun Lien emphasized, "You are only showing a pain in your neck now, which is already a blessing in misfortune." If you let the dissection continue to develop, soon you will start to have symptoms of cerebral ischemia – stroke, you know?"

After receiving a hesitant but positive answer, Sun continued, "Part of the stroke is caused by cerebral ischemia. There is almost no cure for the sequelae of cerebral ischemia – you're only 28 years old, and I don't think you want to spend the rest of your life slumped in bed with your head tilted...... You keep drooling out of your mouth, don't you?"

Sun Lien is now very good at figuring out the patient's mind. Although the two descriptions of slumping on the bed and tilting his head were very shocking to Wang Li, they still did not play a decisive role. As soon as the phrase "drooling out" came out, Wang Li immediately panicked, "Doctor, I'll do surgery!"

For young women, that scene is like hell.

"When your family arrives, we will sign the notification and consent form for the operation. The operating room is ready, and the surgery can begin as soon as it is signed. Sun Lien nodded, the patient himself is willing to undergo surgical treatment, and it will be easier to talk to the family members next. "You contact the family as soon as possible and get them to come to the hospital – just go to the door of the emergency room and I'll talk to them." ”

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The communication with the family was very smooth, and Sun Lien explained the situation to Wang Li's father almost without much effort.

"She's sick...... It has nothing to do with genetics, right?" Wang Lide's father hesitated for a moment after signing and asked, "Her mother lost her ...... because of a stroke a few years ago."

Sun Lien thought for a while and shook his head and said, "I don't know this very well, after the operation is done, I will relay this news to the vascular surgery department - the most urgent thing now is to operate on her first, even if there are genetic factors, the operation must be done first." ”