Writing | Chen Xuezheng Wen Haitao Zhang Sujun
Hunan Province Childrens Hospital
Lele (pseudonym) born 16 days of birth, weighing only 3.1 kg, but intracranial has a huge aneurysm, like a bomb that can be detonated at any time, threatening at all times, threateningHis life of Lele.On August 14, the neurosurgery team of the Hunan Provincial Childrens Hospital implemented the left cervical arterial arteries clip+intracranial hematoma clearance for Lele. Xiaolele re -re -re -re -re -born after 16 days of birth.According to the literature, Lele is currently the youngest in China who treats the youngest giant intracranial aneurysm.
Only 14 hours after birth, Lele appears unknown reasons for convulsions. The local hospital CT and head magnetic resonance vascular imaging (MRA) examination considers intracranial hemorrhage, After symptomatic support treatment, Lele still twitched repeatedly.In order to further treat it, the family members moved to the neonatal department of the hospital under the escort of the Hunan Provincial Childrens Hospitals transfer team.
Lele suddenly trapped into a coma and repeated convulsions after admission. The CTA (CT blood vessel imaging) was told to see a huge aneurysm in the M1 section of the left brain, which is about 2 cm in diameter, and and and more than 2 cm.There are bleeding.
CTA pre-operative CTA prompts huge aneurysm (referred to as arrows)
The situation is critical, the new life is bornPediatrics, neurosurgery, and anesthesia surgery immediately conducted multi -disciplinary consultations to discuss diagnosis and treatment strategies: Lele is young, blood vessels are slender, and they should not intervene in treatment. Cranial surgery has become the only treatment method.However, Leles current basic conditions are very poor. A large amount of bleeding leads to small blood capacity. Comat and unprovoral breathing has further increased the risk of surgery and anesthesia.
In order to ensure the safety of music and reduce the risk of surgery, the multi -disciplinary expert team continues to discuss preoperative discussions to list the possible various risks and make emergency plans.
On August 14, after comprehensive discussion and precise preparation, Lele, who was born 16 days, was sent to the operating room.Because the aneurysm rupture has occurred, a large number of dark red old blood condensation blocks cover Leles entire left brain surface.
After Liu Jingping carefully removed the intra -necked arteries after the dibilities, the sub -absorbum, and the internal hematoma of the cervical artery pool in the microscope.There is a huge aneurysm at the ink of the internal neck arterial arterial, about 2.1 × 2 cm in size, and the blood condens clotter can be seen around the surrounding area and adhesive to the brain tissue.Liu Jingping used aneurysm probes to explore the aneurysm, remove most of the tumor body, and close the permanent aneurysm after shaping the aneurysm.
In the operation, the surgeon was careful and accurate operation. The anesthesiologist always paid attention to and escorted. The surgical team cooperated closely. It lasted for 9 hours and 15 minutes. The operation was finally completed smoothly.After the operation, Lele was sent to the newborn guardian monitoring room. Under the careful care of the multi -disciplinary medical staff, Lele overcome the difficulties, and the current condition has gradually stabilized.
Comparison of CT results after the music pre-operation
Liu Jingping said, Lele ElderlyIn just 16 days, the blood vessels are slender, the basic conditions are poor, the aneurysm is huge and the position is deep, and a aneurysm rupture has occurred, the amount of bleeding is large, the surgical vision is limited, the hematoma is cleared, the aneurysm separation, the aneurysm clip is closed, and the aneurysm clip is closed.If you have a little carelessness in any link, the aneurysm can be ruptured and bleeding again.In terms of technical or physical strength, this surgery is a difficult challenge for the surgery team.
Liu Jingping, director of neurosurgery at Hunan Province Childrens Hospital, check Lele
Liu Jingping introduced that compared with older children or adults, the difficulty of treating the cranial aneurysm during the newborn period is several times higher, especially the extremely low of the newbornThe weight and low blood capacity make the requirements for open surgery very high.
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