The 3.5-year-old Hengheng has many fantastic ideas. Sometimes he imagines himself as a silkworm baby, and sometimes he puts his ears on the ground to listen to the sounds of watermelons, oranges, and stones.
is such a child with a big brain hole. He was admitted to the children's neurosurgery ward of in Xuanwu Hospital. He is waiting for a "brain hole" craniotomy.
01
A 3-year-old boy with a congenital malformation of the skull
is like putting a "tight band" on his brain
This little boy with a lot of whimsy is named Hengheng, only three and a half years old. Looking closely at Hengheng's head, it can be clearly seen that the front and rear diameters of his head are much longer than normal children, and the overall shape is like a winter melon. The disease that causes Hengheng's head changes is called craniosynostosis, which is a congenital developmental malformation of the skull and . A normally developing baby's skull grows and expands in a vertical direction along the cranial sutures. And Hengheng's sagittal suture closes prematurely, which is like putting a tight band on the brain during the stage of rapid brain growth and development.
Little Ruirui in the same ward is only 6 months old, and also a child with craniosclerosis. Rarity's sagittal suture and left coronal suture were closed, resulting in a very pronounced sunken head and asymmetric left and right eye sockets. If it weren't for the obvious deformity, Rarity's parents might not have discovered this hidden disease.
For the usual protruding head, parents usually think that as long as they give their children a "sleep", they can recover. This was the case with Hengheng. It was not until Hengheng got his foot stuck in the bicycle and changed dressings in the local hospital that the doctor recommended a head examination, which helped Hengheng discover the existence of craniosclerosis.
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Treatment of craniosclerosis in the golden period from June to 1 year old The therapeutic effects of different ages are different
In the same ward, the same disease, one is three years old, the other is one and a half years old. Hengheng from Tianjin and Ruirui from Guizhou have gone from strangers to brothers and sisters. The difference is that Hengheng and Xiao Ruirui underwent surgery at different ages, which will fundamentally affect the effect of surgery. The window period for
craniosclerosis treatment is very short, only 4-10 months after birth. This period is the stage of rapid brain development. If surgical treatment is performed in time, it will not affect the development of the brain. The brain has developed to 80% around the age of 3, and surgery during this period can only improve the remaining 20%.
Now, Hengheng is 3 and a half years old, and he has already missed the golden period of treating craniosclerosis. In order to test how the 3-year-old Hengheng's brain is developing, the director of Zeng Gao of the Children's Neurosurgery Department of Xuanwu Hospital specially conducted a psychological development test on Hengheng. The test results show that except for one fine motor, Hengheng has only reached the normal standard, and the rest of the development is very good. This result is due to the education of Hengheng's mother. Since Hengheng learned to speak at the age of 1, his mother insisted on reading picture books to him every day, taking him to play games, and developing his intelligence and athletic ability. Mom's persistence made Hengheng lucky.
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3D skull model printing reduces intraoperative risk
3-year-old boy is optimistic about craniotomy
Although Hengheng and Rui Rui have the same disease, craniosclerosis, but the location, condition and surgical risk of craniosynostosis are very different. The operation of cranial stenosis is like tearing up a complete piece of paper into several small pieces and then splicing them again, which not only tests the skills of the doctor on the tip of the knife, but also tests the adaptability of the surgical plan. Every time before a complicated cranial stenosis operation, the doctor will prepare the printing of the 3D skull model for the operating children. The 1:1 model can restore all the details of the skull, allowing the doctor to plan the operation in advance and reduce the risk during the operation.
In order to prepare for the craniotomy, the doctor came to shave Hengheng's head. Different from the fears of most children in the ward, Hengheng not only opened his mind, but said to his mother, "I have a hair that came from the rain." , and even hummed while shaving her head. Since the hospitalization, his mother has been facing her son's operation with a relaxed attitude, which subtly affected Hengheng's mood, making him feel that "the operation is no big deal".
04
The only way to open the "hoop"
The risk of skull reconstruction surgery is huge
On the day of the surgery, Hengheng was still carrying out his own whimsy. After driving the toy car prepared by the anesthesiology department into the operating room, Hengheng did not cry or make trouble, and was very cooperative. Lying on the operating table, he said, "I feel like a banana," and when he smelled the anesthetic, he said it "smells like biscuits."
For 3-year-old Hengheng, surgery is the biggest hurdle. Skull reconstruction surgery requires opening the scalp, incising the skull, and artificially creating cranial sutures to give the brain enough room to grow. Hengheng's skull has become very hard, which is extremely difficult for surgery. The operations involved in the operation, such as grinding the bones, incising the skull, and punching holes in the skull, not only mean more bleeding, but also the dura under the skull. Risk will follow.
Due to the length of Hengheng's head is too large, if the entire skull is to be completely exposed, the special prone position must be used, but this position should be placed to ensure that the eyes, nose and mouth are all intubated. Can not be squeezed. What Xiao Ruirui's surgery needs to solve is the closure of the sagittal suture and the left coronal suture. Director Zeng Gao used an "H"-shaped operation to loosen Ruirui's brain. Hengheng's surgery made Director Zeng Gao more worried. Hengheng will be given a stamp-shaped osteotomy, which can better shape and decompress. The difficult operation of Hengheng was also performed by Director Zeng Gao. After more than 7 hours of operation, the "tight band" in Hengheng's mind was finally released after 3 years of restraining his brain.
1 in every 2000-3000 children has craniosynostosis. Hengheng is unfortunate, but also lucky. The mother's meticulous care and the superb art of the medical staff saved 3-year-old Hengheng in this "battle".
faces the road ahead, I believe he will be able to brave the storm and move forward bravely!
"Little Science of Life"
What is craniosclerosis? craniosynostosis, also known as craniosynostosis or craniosynostosis, has a neonatal incidence of 0.6/1000. Due to the premature closure of the cranial sutures during growth and development, the cranial cavity is narrow and cannot adapt to the normal development of the brain, which may manifest as increased intracranial pressure, developmental delay, mental retardation, abnormal mental activity, epileptic seizures, and other symptoms. The first choice for treatment is surgery, which aims to expand the cranial cavity, relieve intracranial pressure, enable normal development of brain tissue, and protect vision. Surgery should be performed as soon as possible, and surgery within 6 months to 1 year after birth is effective, and brain dysfunction and head deformity can be significantly improved.
Symptoms and signs:
1. Cranial deformity, which varies with prematurely closed cranial sutures:
(1). All cranial sutures close prematurely, forming a pointed deformity or tower head;
(2). Sagittal sutures Premature closure, forming a scaphoid head or long head deformity;
(3). Premature closure of the coronal sutures on both sides, forming a brachycephalic or flat head deformity;
(4). One coronal suture is prematurely closed, forming a plagiocephaly deformity.
2. Brain dysfunction: Children with low intelligence, lethargy or easily excited, may have neurological symptoms such as epilepsy and weakened limb muscle strength.
3. Increased intracranial pressure: headache, vomiting, papilledema and other manifestations of increased intracranial pressure, optic nerve atrophy, visual field defect and even blindness in the late stage.
4. Ocular symptoms and others: Due to the shallow orbit, it can cause sudden heel and dissociative strabismus. Often combined with deformities of other parts of the body, such as syndactyly (toes), cleft palate, cleft lip and spina bifida.
Warm reminder: When children face serious diseases, medical insurance is particularly important for children and families. Newborn medical insurance is a major benefit given by the state to newborns, which can be used to reimburse medical expenses incurred in hospitalization.
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