Chapter 2858 [2858] Key points of effect


    must face it.


    If he didn''t dare to fight, Song Xuelin would definitely look at them with those eyes again: Just you? Pei ims to be in the same ss as ssmate Xie?


    Raising his head, Pan Shihua faced the monitor screen, his eyes locked on the area where the main knife swept again, and said, "From the current picture, the direction of the cerebrospinal fluid in this ce shows a sign that a vortex is slowing and spinning in ce. The flow below is not smooth. What Yingying said about the trumpet-shaped outlet of the midbrain aqueduct actually refers to the expansion of the outlet end of the midbrain aqueduct after the fourth ventricle dtes."


    "It turns out that the midbrain aqueduct originally grew into a trumpet-shaped abnormality, is that so?" asked Sun Yubo, who is not a neurosurgery specialist. He thought it was such a cause when he first heard it, but now it doesn''t sound like it.


    Mainly because his fellow Huang Daxia didn''te out immediately to exin whether it was true or not.


    In terms of anatomy, looking at the anatomical map, you will find that the midbrain aqueduct is a slender, long and somewhat tortuous tube, unlike theteral ventricle to the third ventricle that only passes through a hole such as the interventricr foramen. Such a structure makes it difficult for the hard mirrors we mentioned earlier to pass through, and we can only use soft mirrors like earthworms or caterpirs to twist and twist slowly.


    As Pan said, the fourth ventricle connected to the bottom of this long thin tube has too much water and overflows and goes up. The lower end of the tube is stretched up, and the outlet of the stretched tube is naturally shaped like a horn.


    In this case, is there something in the fourth ventricle that is blocked near the outlet of the midbrain aqueduct? I mentioned before that this case did not have a space-upying obstruction, and it has been determined to be a traffic obstruction, which is more likely to be a problem in the subarachnoid space below the fourth ventricle.


    The subarachnoid space of the brain is the space between the pia mater and the arachnoid, so it is very deceiving to say that it is a cavity, making people think that it is a cavity simr to the oral cavity, but it is not. More precisely, it is an extended waterwork covering channels and cisterns. The channels are located throughout the brain''s sulci and fissures. Therger areas are called cisterns and are usually called cisternae.


    This waterwork receives the cerebrospinal fluid from the fourth ventricle, allowing the cerebrospinal fluid to function throughout the brain. At the same time, the subarachnoid space of the brainmunicates with the subarachnoid space of the spinal cord, allowing the cerebrospinal fluid to continue to flow to the spinal cord. We talked about how the spinal anesthesia puncture into the subarachnoid space and the flow of cerebrospinal fluid came from here.


    ETV is a fist at the bottom of the third ventricle, that is, a hole is made to allow the cerebrospinal fluid to be diverted directly into the underlying cistern to solve the problem of cerebrospinal fluid umtion.


    From the above, we can know that the focus of this operation to be effective should be on the cause of proximal ventricr obstruction. This means that if the hydrocephalus is caused by the poor outflow from the fourth ventricle to the prepontine cistern, it is not necessarily a space-upying obstruction, such as some other factors that narrow the subarachnoid space. At this time, the shunting of the hole can allow the cerebrospinal fluid in the ventricle to bypass the obstructed segment and flow directly to the cerebral cistern to continue the cirction. Of course, it is effective.


    This matter is known to all neurosurgeons.


    Huang Zhilei couldn''t possibly not know. He nced at Dr. Sun Yubo, a fellow non-neurosurgery specialist: Don''t talk nonsense if you don''t understand. I don''te out to exin it doesn''t mean I don''t understand such a superficial knowledge point.


    where is the problem? How can you judge that it is a proximal ventricr obstruction and not a problem with the subarachnoid space elsewhere?