![\"女孩被飞镖穿颅骨](\"http://01luntan.com/ly_img/uimgs/1496936289208.jpg\" "\\"女孩被飞镖穿颅骨")
脑疝是脑血管病的最危险信号。约有一半以上的病人死于脑疝。因此，在急性期应密切注意病人的呼吸、脉搏、体温、血压和瞳孔变化，及早发现脑疝，并积极进行脱水治疗，控制颅内高压，减少病死率。
\n1、对颅内压增高病人，要准备好抢救物品，随时观察意识、瞳孔、血压、呼吸、脉搏等的改变，及时发现脑疝，早期治疗。一旦发生脑疝，立即通知医生，建立静脉通路，同时快速静脉滴注脱水药，如20%甘露醇250一500 ml，并配以激素应用。有时可合用速尿以加强脱水作用。遵医嘱迅速细致地处理，使脑庙症状能获得缓解，如病变部位和性质已明确，应立即施行手术清除病灶，同时根据医嘱立即备皮、备血，做好药物过敏试验，准备术前和术中用药等。尚未定位者，协助医生立即进行脑血管造影、头颅CI'、或MRI检查，协助诊断。对小脑幕切迹疝，若暂时不能明确诊断或未查明原因且病变不能手术者，可行颞肌下去骨瓣减压术。对枕骨大孔疝，除静脉快速滴注脱水药外，还应立即行额部颅骨钻孔脑室穿刺，缓慢放出脑脊液，行脑室持续引流，待脑疝症状缓解后，可开颅切除病变。
\n2、除去引起颅内压增高的附加因素：
\n①迅速清除呕吐物及呼吸道分泌物，保持呼吸道通畅，保证氧气供给，防止窒息及吸人性肺炎等加重缺氧。
\n②做好血压、脉搏、呼吸的监测。血压过高或过低对患者的病情极为不利，故必须保持正常稳定的血压，从而保证颅内血液的灌注。
\n③保持良好的抢救环境，解除紧张，使之配合抢救，同时采取适当的安全措施，以保证抢救措施的落实。
\n④高体温、水电解质紊乱和酸碱平衡失调等因素均可进一步促使颅内压升高，也应给以重视。
\n3、对呼吸骤停者，在迅速降颅压的基础上按脑复苏技术进行抢救：
\n①保持呼吸道通畅，给予气管插管，必要时行气管切开;呼吸支持，可行口对口人工呼吸或应用简易呼吸器或人工呼吸器，加压给氧。
\n②循环支持：如心跳停止立即行胸外心脏按压，保持心脏泵血功能。
\n③药物支持：根据医嘱给呼吸兴奋剂、升压药、肾上腺皮质激素等综合对症处理。
\n4、昏迷病人要保持呼吸道通畅，及时吸痰。排痰困难者，可行气管切开，防止二氧化碳蓄积而加重颅内压增高。观察电解质平衡的情况，严格记录出人液量。患病3d后不能进食者可行鼻饲，并做好胃管的护理，留置胃管后应每日2次口腔护理，定时翻身，认真做好各项基础护理，保持床铺平整、干净、柔软，保持局部皮肤干燥，预防褥疮发生。对有脑室穿刺引流的病人，严格按脑室引流护理。大便秘结者，可选用缓泻剂疏通，有尿潴留者，留置导尿管，做好尿、便护理。
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脑疝患者怎么护理
1.临床证实，对所有脑出血患者应用皮质类固醇治疗，并未显示任何好处，但仍需应用这类药物来预防继发的脑疝和最大可能地保持意识清醒。
2.临床推荐，初次剂量10mg～12mg地塞米松静注，随后每6小时给4mg。渗透性利尿剂甘露醇每4小时静脉快速滴入100g，预防因颅内压增高引起的急性脑疝。
宜与忌
1.观察患者神志意识，生命体征。
2.保持呼吸道通畅，必要时吸氧或进行人工换气。
3.如为钩回疝，应立即输注甘露醇、激素;如为小脑扁桃体疝，应立即人工辅助呼吸。紧急时作侧脑室空刺放液，并尽快查明病因，酌情手术切除病变部位或施行减压术。
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于2006年发现有手指抖动症状。渐进出现活动僵硬症状。目前不能自理，运动困难。搀扶可以走路。睡觉不能自主翻身。想问问神经外科是否能做脑内深部电极植入？整个治疗过程需要多长时间？电池需要多久更换？电池能否充电？整个费用怎样？或者是否还有更好的治疗方案？谢谢
","barId":"1690","topicTypeId":null,"topicThemeId":"1020","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":2},{"id":"1143","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"吃德巴金起了皮疹怎么办?","content":"2015年六月第一次发作，没有意识到是这个病，未就医。2016年四月第二次发作，去甘肃中西医结合医院确疹为癫痫开始每天吃一片德巴金，每三十几天发作一次，都是大发作。八月四号去唐都作全面检查，八月八号开始加量，控制的挺好，就是身上痒，有皮疹。
德巴金加量后效果理想，就是出现皮疹，望指导！
脑疝大家应该都不熟悉，我也是最近听同事说起才知道原来还有这样的一种疾病，但是不要小看这种疾病，脑疝是一种很严重的脑部疾病，出于好奇心我特意收集了一些关于脑疝的主要症状的一些文章，丰富下自己的知识面，下面我给大家分享下脑疝有什么症状。
\n一小脑幕切迹
\n1.颅内压增高的症状：表现为剧烈头痛及频繁呕吐其程度较在脑疝前更形加剧并有烦躁不安
\n2.意识改变：表现为嗜睡浅昏迷以至昏迷对外界的刺激反应迟钝或消失
\n3.瞳孔改变：两侧瞳孔不等大初起时病侧瞳孔略缩小光反应稍迟钝以后病侧瞳孔逐渐散大略不规则直接及间接光反应消失但对侧瞳孔仍可正常这是由于患侧动眼神经受到压迫牵拉之故此外患侧还可有险下垂眼球外斜等如脑疝继续发展则可出现双侧瞳孔散大光反应消失这是脑干内动眼神经核受压致功能失常所弓[起
\n4.运动障碍：大多发生于瞳孔散大侧的对侧表现为肢体的自主活动减少或消失脑疝的继续发展使症状波及双侧引起四肢肌力减退或间歇性地出现头颈后仰四肢挺直躯背过伸呈角弓反张状称为去大脑强直是脑干严重受损的特征性表现
\n5.生命体征的紊乱：表现为血压脉搏呼吸体温的改变严重时血压忽高忽低呼吸忽快忽慢有时面色潮红大汗淋漓有时转为苍白汗闭体温可高达41℃以上也可低至35℃以下而不升最后呼吸停止终于血压下降心脏停搏而死亡
\n二枕骨大孔疝：病人常只有剧烈头痛反复呕吐生命体征紊乱和颈项强直疼痛意识改变出现较晚没有瞳孔的改变而呼吸骤停发生较早
\n三大脑镰下疝：引起病侧大脑半球内侧面受压部的脑组织软化坏死出现对侧下肢轻瘫排尿障碍等症状
\n大家看完以后相信已经对脑疝这种疾病的主要症状了解一些，这种疾病还是比较厉害的，建议大家发现以后一定要去正规的医院就诊。
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引起脑疝的原因是什么
\n颅内任何体积较大的占位病变引起颅腔内压力分布不均时都可引起脑疝。病变在幕上者引起小脑幕切迹疝，病变在幕下者引起枕骨大孔疝。引起脑疝的常见病变有：
\n1.损伤引起的各种颅内血肿，如急性硬脑膜外血肿、硬脑膜下血肿、脑内血肿等;
\n2.各种颅内肿瘤特别是位于一侧大脑半球的肿瘤和颅后窝肿瘤;
\n3.颅内脓肿;
\n4.颅内寄生虫病及其他各种慢性肉芽肿。在上述病变的基础上如再附加一些人为的因素，例如作腰椎穿刺释放过多的脑脊液，使颅腔与椎管之间、幕上分腔与幕下分腔之间的压力差增大，可促使脑疝的形成。这种由于医源性因素造成的脑疝，临床医师应予避免。
\n\n
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浙青网-青年时报消息，正在教室安静写作业，谁知一个“火影忍者”飞镖忽然飞来插入头顶。昨天下午，杭州某学校11岁女生雯雯被紧急送到浙江大学医学院附属儿童医院神经外科。
飞来横祸插入头顶飞来横祸插入头顶
昨天下午5点多，浙大儿院神经外科副主任医师沈志鹏接到急诊求助。赶来一看，一个女孩左侧头顶被插入一个飞镖。雯雯家长反映，雯雯下午课间时在教室里写作业，同班的同学在玩飞镖时不慎将她砸中。
“可以看得出，这个飞镖仿真度特别高，是金属制品，飞镖的一角像针刺一样牢牢插入头顶左侧。飞镖插入多深？是否伤及脑实质？这些都需要进一步探查。”沈志鹏告诉记者，当时，神经外科立马为雯雯做了CT，检查发现，飞镖一角穿透头皮2cm，但具体伤到什么程度，只能通过手术才能发现。
术前，雯雯的家长十分紧张。“当时有两个方案，一个是直接清创拔出，另一个则需要打开头皮颅骨进一步探查，但对雯雯的创伤无疑是非常大的。在经过反复研究讨论后，家长决定清创拔出。” 沈志鹏说，“昨天晚上10点，手术开始了，手术过程中，我们发现已经穿透整个颅骨，所幸的是被颅骨下一层黏膜挡住，没有损伤到脑实质。”
整个手术进行了一个小时。术后，雯雯的状态比较好。今天上午查房时，雯雯表示除了伤口处还有点疼，其他也都好。沈志鹏谈到，接下来还要观察伤口是否会继续感染，需要核磁共振再检查，如果没有其他问题，过3-5天就可以出院了。
\n
网上仿真玩具太多风险大
近几年，沈志鹏遇到形形色色的患儿，可被飞镖砸中插入颅骨的还没有遇到过。这样的玩具也让不少家长感到担忧。
对此相关网友如下表示：
\n秋风素意：强烈建议家长一定要看管好自己的小孩，不要孩子要什么就给，万一那天小孩说要把刀，难道家长真的去买吗？出了这样的事，家长先反省反省
你是绿色酿的酒：子不教 父之过 这家长也是有病 小孩子玩这样杀伤性玩具也不知道管管或者叮嘱不要在人多的地方玩
狙肉脯哈你切：所幸没有生命危险这让女孩子们对顽劣男同学的印象更加坏了
微梁平：学校的管理跟上了吗？这些东西根本应当严禁带入学校。
小小鸟小小人666：这样还怎么让我们放心的把孩子交给学校！还有这些没脑子的家长！什么都给！哪天说给毒药小孩自己吃，也给么！！！
宸睿小王子：幸好孩子没有生命危险！可是这也必然对她生活完成严重影响。严查管制刀具和利器。
\n
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我儿子三岁发过癫痫，（右手右脚抽），在昆明市儿童医院照ct诊断为左脑穿通畸形，吃德巴金5年，十来年未再发癫痫，在2015年和2016年又再发过二三次，并时有头痛头昏症状，是右边痛，在昆明市第一人民住院半月，拍核磁共振和Ct诊断为蛛网膜襄肿，医生认为和小时候拍的片子对比没什么变化，建议再观察一段时间再决定是否手术，现我孩子吃德巴金，病情有缓解，他已满19岁，现想咨询一下，我儿子是否需要手术治疗？
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