However, after ten days or so, Mr. Carlris's illness did not improve, but became more and more serious.

Don't talk about getting up, as soon as you sit up or stand up, the pain will be unbearable within a few minutes, and you need to lie down.

This disease, which occurs without "lying down", is really a headache!

Although Mr. Carris has long since retired, he has accumulated enough wealth when he was young to ensure that he has no worries in his old age, and he does not need to go to work at a great age, which can be regarded as "lying flat" for many years.

When Mr. Carris came for a follow-up visit for the first time, Dr. Rachel understood the condition, groaned slightly, and suggested another head CT.

Because it was not detected at the initial diagnosis, it may be because the disease is mild, and the disease has progressed for a period of time, perhaps, the cause can be found.

Sure enough, I didn't know if I didn't check it, and I was shocked when I checked it, and the CT scan showed that there was an inexplicable extra layer of blood on the surface of Mr. Carlris's brain!

At the time, Dr. Rachel watched the film and fell into deep thought.

The Carlris couple's hearts were lifted, and they were uneasy. I'm not afraid of the doctor joking, I'm afraid that the doctor will become serious.

"Dr. Rachel, is my husband's illness serious? How did it happen? Mrs. Carris asked.

Rachel pondered for a few seconds and asked, "Does Mr. Carlris usually take aspirin, clopidogrel and other drugs?" Or, have you fallen or hit your head in the last month or two? ”

Mr. and Mrs. Carris looked at each other, recalling them for a moment, and shook their heads.

"I've taken painkillers recently, and the rest of the time because of headaches, I lie down most of the time, and I don't have the opportunity to go out, so I won't have a chance to hit my head." Mr. Carris said suspiciously.

Rachel said: "Your condition, consider the subdural hematoma, look at the film your blood has been out for a while, part of it has been liquefied, fortunately the blood is on the surface of the brain, not in the brain, and the amount of bleeding is not large, no surgical intervention is required, take some medicine may slowly absorb it by itself, there will be no sequelae." ”

So, the hanging hearts of the Carlris couple were put down again. It's good if it's not serious.

After the first follow-up visit, Dr. Rachel recommended atorvastatin tablets, which in addition to lowering blood lipids, also promote the absorption of subdural hematoma, depending on the patient's condition, the dosage was one tablet a day, and Mr. Carris came back for a follow-up CT in two weeks.

Within two weeks, Mr. Carlis, accompanied by his wife, came to Rachel again, because his headache had not improved at all, and they did not want to delay it to a more serious point.

Dr. Rachel arranged for a CT of the head again.

Reports show that the blood on the surface of Mr. Carrris's brain shows some signs of absorption, but the symptoms do not abate.

Rachel: "......"

In a daze, it seems that I have to ask the boss for help.

At this time, for the second follow-up visit, Zhou Qiao and Murphy had already returned from Northern Europe and had just arrived at the Iris Clinic for two days.

Rachel took the patient and the report to Zhou Qiao's office.

"Mr. Carlris, don't worry too much, with Dr. Zhou here, we should be able to find out the cause of the disease quickly." Dr. Rachel said apologetically.

Mr. and Mrs. Carris were also full of expectations, having heard that Dr. Zhou Qiao of the Iris Clinic was young and promising, and was a top-notch multidisciplinary medical expert.

In Zhou Qiao's office, Zhou Qiao looked at the film, asked about the specific symptoms, and said, "This is considered for low cranial pressure headache." Mr. Carlis, your head may be leaking. ”

"What?"

Not only were Mr. and Mrs. Carlis confused, but even Dr. Rachel was slightly stunned. The heart said that Dr. Zhou is amazing, why didn't I think of it before?

In fact, this is the domain of neurosurgery, which is beyond Rachel's ability.

Seeing that everyone was puzzled, Zhou Qiao smiled slightly and explained carefully: "Our human brains are actually soaked in water, normally, these waters are fluid, and can maintain a certain pressure, once the water pressure in the brain is reduced, people will feel headaches." As for why the water pressure decreases, it may be that there is a place in the lower spine that keeps leaking water. The leaked water is absorbed by the tissues and does not leak out of the body. ”

Mr. Carlris is still suspicious, what does the leak have to do with my headache? So he asked, "Dr. Zhou, why doesn't it hurt when I lie down?" ”

Zhou Qiao said: "After lying down, the water pressure in the brain rises, and there is less leakage below, and the headache is naturally relieved." ”

Mr. and Mrs. Carris and Dr. Rachel nodded suddenly.

Dr. Rachel thought to herself, and learned another point, how good would it be if she were a few decades younger? Then you can learn more from Dr. Zhou. Although it is not too late to learn now, the potential is limited after all.

Look at Murphy, Stephanie, and Nanako Chiba, learn from Dr. Zhou, and grow so fast! How enviable!

Mrs. Carris asked, "Is the bleeding in my husband's brain also related to a water leak?" ”

Zhou Qiao nodded and said, "Of course it matters." The decrease in pressure in the brain will induce blood, and in severe cases, it will even lead to brain herniation or swelling of the whole brain, which is life-threatening. ”

"So what now?" The couple looked at each other, a little anxious. In addition, if you are so old, if you have to have surgery, I don't know if your body can support it?

There are many people who are old and have surgery, but after the operation, their bodies collapse and become too weak to look good, and then they have a funeral within a few years of living.

Mr. Carris didn't want that.

Although he is over seventy, he still wants to live another twenty or thirty years!

If you have surgery, you will be cured, but the body will be injured and your life will be shortened, which is not worth it.

Zhou Qiao comforted: "It's okay, hospitalize first, do a whole myelography to clarify where the leak is." Then do a minimally invasive surgery to make up for it. The specialty of our iris clinic is that we have probably heard of it, and what we are best at is minimally invasive surgery, not only for the heart, but also for many other procedures. All in all, we are all minimally invasive if we can be minimally invasive. ”

"Yes, yes." Mr. and Mrs. Carlis nodded repeatedly. It is said that Dr. Zhou also often creates his own minimally invasive procedures, which are published in core journals. News about the Iris Clinic is often reported on TV and in newspapers.

Moreover, they are not only good at minimally invasive, but also very good at those "big engineering" surgeries, such as heart transplants. No, a few days ago, many media in San Francisco were still reporting that it was the latest news from the Nordic side, that Dr. Zhou and the cold Miss Murphy performed heart exchange surgery on the twin princess's own great-aunt and grandmother.

I have to say that those rich and powerful people just enjoy privileges, they are all ninety-eight years old, and they can change the young heart of a little girl.

And the elderly of ordinary people, where do they have that kind of opportunity. I can't even think about it.

Zhou Qiao called Park Xiuzhu and took the two to the community hospital, arranged in the neurosurgery ward, and perfected a series of routine examinations, and then, Zhou Qiao personally took action and performed a lumbar puncture for Mr. Carlis, and the measured pressure was as high as 250 mm water column.

Normally, the pressure value of the lumbar puncture is between 80-180 mm of water, and if the patient's lumbar puncture pressure exceeds this range, it is considered an abnormal condition. If the patient's lumbar puncture pressure is less than 80, it is also normal and does not require excessive concern and no special treatment.

Lumbar puncture, a clinical operation to extract cerebrospinal fluid or inject drugs by puncturing the lumbar intervertebral space, is not only an important means of diagnosing meningitis, cerebral hemorrhage and other diseases, but also a key step in the treatment of spinal anesthesia.

In the eyes of many people, this operation seems to be relatively risky, and just hearing the word makes people feel frightened, but in fact, lumbar puncture has developed into a relatively safe and accurate operation in modern medicine.

This method is mainly used to diagnose diseases of the central nervous system, such as encephalitis, meningitis, subarachnoid hemorrhage, cerebral hemorrhage, etc. It can also be used to measure intracranial pressure.

And Zhou Qiao is a "national player", a perfection-level level, and it is not worth mentioning to do this kind of minor surgery.

"When the pressure is high, the head hurts, and due to the hemorrhage inside the skull, your condition has evolved from low intracranial pressure at the beginning to high intracranial pressure now." Zhou Qiao explained to the patient.

Subsequently, after injecting the contrast agent into the spinal canal, Zhou Qiao arranged for Mr. Carliss to have a full-slice thin-slice CT of the spine.

He is a detached presence in the community hospital, and his needs will be met as soon as possible.

And some other doctors who are also affiliated with the same are not necessarily.

Soon, a thin-slice CT scan with a thickness of 0.6 mm was transmitted to the computer, and more than 1,000 images were taken in total.

Zhou Qiao called Murphy, Stephanie, and Nanako Chiba to consult and discuss together, and several doctors from the neurosurgery department of the community hospital came to study with them.

This is a rare opportunity.

Everyone sat around a small conference room, projecting the 55-inch 4K HD screen, looking for frame by frame, for fear of missing any detail.

Murphy was in charge of playing, and after a while, her finger stopped, zoomed in, and said, "This is it." ”

Sure enough, you can see that the contrast agent is well filled in the place shown on the screen, and a small amount of contrast agent can be seen at the thoracic level 5 into the epidural space.

Zhou Qiao nodded: "That's right, the leak is definitely here!" ”

"However, it is not ruled out that there are leaks elsewhere." Stephanie said.

So, everyone worked together, turned over and over, watched more than 1,000 films several times, eliminated leaks in other places, and confirmed that there was only this one.

When Mr. and Mrs. Carris heard the news, they finally breathed a sigh of relief, and said that Dr. Zhou was amazing.

This is the advantage of coming to the iris clinic to see a doctor, Rachel can solve the minor illness, and if it really can't be done, they can invite the top doctors in North America to consult at any time.

Moreover, in this kind of private clinic, the experience is much stronger than going to a big hospital like the University of California Medical Center. For example, the service is more attentive, the arrangement is faster, and so on.

The leak was found, and the operation began.

It's a super little surgery.

Local anesthesia, injection, minimally invasive, 10 minutes!

"Oh my God, so fast?" After the operation, Mr. Carris was amazed, and this is done?

Zhou Qiao smiled: "Don't look fast, the technical content is very high!" ”

"Yes, yes, it's really high!" Mr. and Mrs. Carlris gave a thumbs up at the same time. The simpler the method of curing this strange disease, the more it can show the level of the doctor.

That's the magic of a famous doctor.

It's also quite easy to understand. For the same condition, ordinary doctors toss and turn, drastic measures, and the patient is seriously injured, not to mention the crime, and it may not be cured.

And the famous doctor called it a day after an injection. Judge from above!

"It's a difficult needle, but the principle is very simple." Zhou Qiao thought about it, then made an analogy and said, "It's like the science fiction movies we usually see, in the universe, the spacesuit suddenly leaks, what should I do?" ”

"What should I do?"

"It's as simple as taping the air leak with special tape. But the right tape is needed to mend the spacesuit, and the right tape is needed to mend the leaks in the brain. This tape is its own blood. ”

Just now, Zhou Qiao performed surgery, which was to draw 20 ml of venous blood from the patient's body, and slowly inject it into the epidural space near the leak while it was hot (when it was not yet coagulated).

In this way, the blood forms an 'iron wall' on the outside of the leak.

Over time, the blood is slowly absorbed by the body, but it can also cause inflammation in the surrounding tissues, and the hypertrophic fibers will gradually form new 'walls' to replace the blood clots, and the leak will be completely blocked.

This method is very ingeniously conceived, not only is it less traumatic, it is convenient and fast, and if it recurs in the future, it can also be repeated repeatedly.

Zhou Qiao had surgery, since his debut, he has not tasted a defeat, this epidural blood patch, if other doctors come to do it, there may be a chance of failure, but for Zhou Qiao, the success rate is 100%.

The top famous doctor is so arrogant.

"Of course, there are some precautions after surgery, you need to stay in bed for a period of time, you can't sit up, you can't get out of bed and walk, and drink more water at the same time, it should be about the same after two weeks, and then you will recheck the head CT to evaluate the effect. The atorvastatin medication recommended by Dr. Rachel can be taken continuously. ”

On the third day after surgery, Mr. Carris was discharged from the hospital and went home to continue "lying flat".

Two weeks after the operation, I came for a follow-up examination, and sure enough, the CT film showed that the subdural blood had been significantly absorbed, and the lateral ventricles were also larger than before, indicating that the patient's intracranial pressure had tended to be normal, and he could try to get out of bed.

"It's really amazing." Mr. and Mrs. Carris were delighted. First, the recovery is fast, and second, there is only one eye of the needle, and when I had surgery before, the whole process was painless.

The incidence of brain leakage is not high, some will appear after spinal stretching movements such as yoga, trauma, surgery, and some are unknown.

Such patients sometimes have symptoms that are not so typical, and may also be accompanied by dizziness, nausea and vomiting, facial numbness, tinnitus, diplopia, etc., in addition to coma, dementia, fever, hyperprolactinemia, intracranial venous thrombosis, etc.

Due to its complex clinical manifestations and the diversity of imaging features, it is difficult to diagnose, and even one-third of patients with low intracranial pressure The pressure measured by lumbar puncture is normal or high, so it is very easy to be ignored.

Rachel, Vivica, and Jenard are also very aware of their position in the clinic, so they are not discouraged.

What's so frustrating about this? If you can't solve the problem, just "refer" it to the boss. The job responsibilities are just different.

(End of chapter)