Chapter 1521: Chapter 615: Brain Injuries—Visible and Invisible, In-Depth Examination of the Spinal Cord
“The child’s right side of the neck shows rigidity, and his right leg knee-jerk reflex is weak, which indicates an issue with the nerve conduction pathway. Additionally, the smoothness of the lower-level neural centers doesn’t imply all neural centers are clear. Coupling this with the noticeable hematoma on the neck after the child’s high fall, we can conclude there is injury to the cervical spine, and it’s very likely that the spinal cord is damaged.”
Director Yin, seeing he agreed, began discussing the child’s etiology earnestly.
Whenever discussing etiology, he naturally showed this serious expression, appearing meticulous.
Being a top expert in the Neurology Department undoubtedly means having outstanding skills.
The rigorous attitude toward medicine is indeed something to learn from.
“Besides the possibility of damage to the cervical spinal cord, I believe this child’s brain is likely also damaged.”
Director Yin continued.
Damage to both the brain and cervical spinal cord, this is what Director Yin referred to as a plex neurological disease.
“But the CT and ultrasound of the child’s head showed no abnormalities!”
CT has strong diagnostic significance for tissue lesions, tumors, and vascular anomalies. When checking the head with ultrasound, it generally assesses the blood supply to the head.
Any pressed blood vessels, ruptured blood vessels, etc., are effectively checked.
Having carefully reviewed the child’s test reports, no abnormalities were found.
He considered his image reading ability honed over the years was strong, and with the diagnosis level raised to Director Level, his surgical skills in various medical departments also reached the Director Level. His ability to read scans was even superior to that of ordinary chief physicians and technicians in the Medical Technology Department.
He could spot the minor issues others might miss.
“Brain damage sometimes cannot be detected through ultrasound, CT, or X-rays. Even the highest precision MRI might fail to detect it. Since brain tissue is as delicate as soft tofu, when the head undergoes severe impact, problems can arise. Especially with young children, where the skull has just pletely fused, and the body is still tender with many organs not fully developed, making them more prone to damage.”
“For example, the most mon one is a concussion.”
Director Yin offered his diagnostic insights.
This also provided Zhou Can with more diagnostic inspiration.
“You mean to simultaneously focus the examination on both the child’s brain and cervical spinal cord, correct?”
“Exactly!”
Director Yin displayed a look of satisfaction as though teaching a promising pupil.
“Additionally, I can give you another diagnostic reference direction. Some patients inherently have diseases, but they haven’t manifested yet, or the symptoms are not obvious. Particularly during the prodromal stage of a disease, symptoms are often subtle. Let me give an example, could it be possible that this child inherently had nerve or spinal cord disease, and this high fall injury served as a trigger, causing the disease to erupt and suddenly leading to high-level paraplegia?”
This is indeed another highly experienced diagnostic approach.
It’s rare for young doctors to think along these lines.
Zhou Can came to visit Director Yin this time and gained a lot, ready to stand up and take his leave.
“Don’t be in such a rush to leave, I haven’t finished yet!” Director Yin glared at him dissatisfied.
Zhou Can had no choice but to sit back down.
“The spinal cord has two enlargements, the upper one called the cervical enlargement, located from the third cervical to the second thoracic segment. The lower one is the lumbar enlargement. When patients have typical spinal cord-type paralysis, focus on these two areas. For this child’s high-level paraplegia, I suggest focusing on checking the cervical enlargement. If necessary, you can perform a puncture examination or minimally invasive exploration. In terms of invasive exploration, if there’s something you don’t understand, you can consult Neurosurgery’s Director Wu, as this is his specialty.”
Director Yin provided another diagnostic opinion.
All this stemmed from years of accumulated experience, now shared selflessly with Zhou Can, making him very grateful.
After Director Yin finished, Zhou Can sat still, quietly watching him.
“That’s all, I’ve provided all the opinions I can. What else do you want to hear? How about I share a few classic high-difficulty neurologic cases next time?” Director Yin asked teasingly.
“Uh… I’ll be back next time, definitely next time. Today I’ve received so much wisdom from you, I need to go back quickly and apply it because that paraplegic child is still waiting! Thank you for your diligent guidance, I’m off now!”
Zhou Can stood up and waved repeatedly.
“The tea here is really good, actually our Emergency Department also has good tea. As long as you e over, I guarantee I’ll sneak out Director Lou’s best tea leaves to brew for you.”
This was a joke.
Zhou Can is now the deputy director of the department. To keep him engaged, the department has specially arranged an office for him.
Even Han Changqing, the deputy director with much more seniority than him, doesn’t have this privilege.
However, Director Han is about to retire.
He doesn’t seek such formalities; what Director Han likely desires is post-retirement security.
For doctors with tenured positions, their post-retirement salary usually isn’t less than 80% of their pre-retirement salary. Therefore, everyone tries to make as much progress as possible before retirement to elevate their level.
When the time es, they can receive a higher retirement salary.
Zhou Can has his own tea leaves, even better than what Director Lou has in his collection.
Moreover, his tea selection is varied.
Being one of the behind-the-scenes bosses of Golden Entertainment Interactive pany, although he keeps an extremely low profile, those who aim to advance, when giving gifts to Li Lao, always sensibly bring something for Zhou Can as well.
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