My Medical Skills Give Me Experience Points

Chapter 1554: Chapter 630: Trouble Caused by Cerebral Gray Matter, It’s a Kind of Feeling_2

"Enlarge the patient’s head scan images for a closer look. I should have done an ultrasound for more accuracy, but the CT images will have to do."

The biggest advantage of ultrasound is that it can provide real-time imaging of blood flow within vessels.

It’s used to determine if the blood flow in the vessels is smooth, and its accuracy and diagnostic value often surpass many high-precision instruments.

Some young medical practitioners blindly worship the high clarity and precision of MRI.

In fact, this is an incorrect clinical diagnostic mindset.

Ultrasound, B-ultrasound, X-rays each have their own advantages. They continue to be used and have not been eliminated because they have their merits.

A simple ultrasound costs just over a hundred yuan, but how much does an MRI cost?

At least several hundred, and the more precise ones can cost over two thousand yuan.

When it comes to diagnosing vascular patency, aside from CT angiography, there really is no other method more intuitive than ultrasound.

Wu Baihe closely examined the patient’s head CT images.

"Enlarge this part a bit more."

After enlargement and reviewing for a while, Wu Baihe was still a bit indecisive.

"The patient has also had a head MRI at an external hospital, right? Let’s take a look at that too."

He appeared very meticulous.

Even though he’d spotted the issue following Zhou Can’s reminder, he still wanted to gather examination data as support. This is an inherent mindset of most seasoned doctors.

Just two words, being prudent.

Why is this the case?

Because many seasoned doctors have been litigated by patients and their families. In court, you have to present evidence!

When doctors defend themselves, verbal claims alone are naturally not credible.

At this point, providing examination data and informing the judges or departmental staff that the patient treatment was based on this data, adhering strictly to medical protocols.

Then, when the administrators review the evidence, it stands as valid.

As long as it’s proven that there was no malpractice during diagnosis and treatment, the case is typically won.

Surgery has strict indications.

Doctors can’t just decide to perform a surgery because they suspect an artery supplying the brain matter is problematic.

That would definitely be improper.

Issues must be identified from the examination data before deciding on a surgical solution.

Failing to detect this vascular lesion before surgery is actually considered a missed diagnosis.

However, this is very common in clinical surgery.

Some lesions are extremely concealed, even experienced doctors find it tough to diagnose them.

There’s a type of examination called intraoperative exploration.

It’s used to conduct further exploration of the lesion area during surgery.

This highlights that a doctor holds significant authority during surgery. The system’s regulations are somewhat lenient on surgical practices.

This bears the notion of a strict entry and full autonomy once the surgery begins.

This is essentially an unwritten rule of current medical surgeries.

However, in recent years, regulatory departments have formulated some stringent oversight policies. For example, during surgery, the nurse, anesthesiologist, and physician assistant all have to sign confirmations. Additionally, the surgical process is accurately logged.

If the records are non-standard or conceal something, upon discovery, not only will the involved doctors and nurses be held accountable,

but even the hospital will face penalties.

But ultimately, hospitals back their doctors and nurses, so any real issues are typically handled privately. Achieving true transparency in the operating room is almost impossible.

It’s like installing surveillance in kindergartens; if parents demand to monitor how teachers educate their children, no kindergarten would dare agree to that.

"County-level hospitals are unreliable; they can’t even perform an MRI properly. Their skill level means their medical technicians deserve to be laid off and retrained."

Wu Baihe criticized the county-level hospital’s MRI competence.

The rest kept quiet.

Some were suppressing smiles.

"Though the imaging is fuzzy, you can vaguely tell that the vessel indeed has narrowing, and it looks quite severe. This vessel is small, and typically, its task of supplying blood to the brain matter is relatively light. Unexpectedly, it had a problem, indicating our oversight before the surgery. Director Zhou, how do you intend to handle this narrowed artery?"

Having identified the issue, it was time to address it.

There were two solutions.

Zhou Can was somewhat troubled.

"Placing a vascular stent would be safer and faster, but it might be more expensive. Replacing this segment of the vein would cost less, but the operation is more complex, risky, and causes more trauma to the patient. The patient is currently very weak, so opting for a stent would be better."

After deep consideration, he leaned towards the safer, albeit more expensive, treatment.

This is basically the choice of all doctors.

Because nobody wants things to go wrong.

"I also favor the stent solution. The circulating nurse should urgently prepare the stent based on Director Zhou’s requirements."

"Okay."

The circulating nurse inquired about the specific needed diameter and length of the stent from Zhou Can and immediately called to prepare it.

"Director Wu, I’ll check here, and if there are no issues, we’ll conclude the endoscopic surgery." Zhou Can mentioned.

"Mm."

Wu Baihe nodded.

Zhou Can secretly sighed in relief; good that he hadn’t immediately explored the brainstem area.

Who would’ve thought the issue wasn’t in the brainstem, but the brain matter?

The bleeding at the patient’s thalamus had increased intracranial pressure, further compressing the already narrowed artery, nearly obstructing blood flow to the brain matter. This was the primary cause of the patient’s coma.

Now, the truth was unveiled.

Next was to conduct interventional surgery to place a vascular stent, clearing the nearly blocked artery.

"Director Qu, are there any changes in the patient’s brain waves?"

Before retracting the endoscope, Zhou Can still had some concerns.

"The brainwaves have become more active, seemingly in recovery."

She replied.

In a state of general anesthesia, brainwaves are relatively smooth. However, as the intracranial hematoma was drained, bleeding stopped, and intracranial pressure decreased, the compressed artery began to rebound and blood flow somewhat restored.

The nearly halted brain matter function resumed again.

"It seems right that the brain matter is the culprit," Zhou Can felt more assured.

...

Conducting interventional surgery is Zhou Can’s forte.

The entire stent placement process took just under twenty minutes.

After the surgery, the severely narrowed, nearly blocked artery was cleared, and blood flow was restored.

Post anesthesia recovery came the good news.

The patient had awakened from the coma.

This complicated, risky intracranial surgery was finally a resounding success. It offered Zhou Can deeper insight into intracranial and neurosurgery.

He deeply realized that medicine is boundless, a lifelong learning journey.

"Director Zhou, may I ask how you realized that the artery had an issue during the surgery?"

A neurosurgeon in his forties, with most of his hair turned gray, approached conscientiously.

After the surgery, he found an opportunity to seek advice from Zhou Can.

Attending Zhou Can’s intracranial surgery today, he found many aspects astounding.

He witnessed firsthand what being a surgical expert entailed.

Zhou Can’s craniotomy, intracranial hemostasis, lesion discovery, and endoscopic operations all left them in awe. Most surprising was Zhou Can identifying an artery problem.

At the time, only a small segment of brain matter was visible.

He thought the possibility of deducing arterial lesions from brain matter was slim.

Even their teacher, Wu Baihe, only reached this diagnosis after thoroughly observing the brain tissue for a while.

"Would you believe me if I said it was instinct?"

Zhou Can looked at his fellow colleague.

Many doctors with graying hair early in life face immense pressure from studies, research, exams, and clinical practice.

Sometimes when examining a critically ill patient, the greatest concern is not from the family, but from the doctor.

Every doctor who grays by their thirties or forties deserves respect.

Because they have dedicated their entire mind and body to medicine, contributing their modest effort to human medical progress.

"I believe you! Could you elaborate, I too wish to have such instinct."

Upon hearing this, other doctors, even nurses, gathered around. Like stars surrounding a moon, they enclosed Zhou Can.

"Once you finish asking Director Zhou, please rest. You’ve all worked hard today. I’m getting older, so I’m heading home to sleep." Wu Baihe felt slightly awkward.

In today’s surgery, he was assisting Zhou Can behind the scenes.

He even called most of the elite team members to help.

Unexpectedly, it turned into a showcase for Zhou Can.

Though not quite envying him, his own esteemed reputation undoubtedly felt somewhat shaken.