Xiaoyou (pseudonym), a 13-year-old girl with leukemia, suffered an acute cerebral infarction and paralyzed the left half of her body. Multidisciplinary experts from the Children's Neurology Center of Wuhan Children's Hospital raced for her life to seize the "window period" for surgery and urgently intervened in thrombolysis to treat the blocked cerebral blood vessels. Opening the "channel" preserved her nerve function and avoided "hemiplegia". The day after the operation, she was able to lift her hands and feet, get out of bed and walk, and basically returned to normal life.
A girl with leukemia suffered a sudden "stroke"
html On August 31, the reporter saw Xiaoyou in the ward. She was smiling broadly while sitting on the hospital bed. "Now she can speak clearly and can move her hands and feet. Her condition has improved a lot." Xiaoyou's mother thanked the doctors for their timely discovery and treatment.Xiaoyou's family is in Xianning, and she is an ill-fated girl. In April this year, Xiaoyou was diagnosed with acute lymphoblastic leukemia and underwent chemotherapy treatment in Wuhan.
Neurologist Feng Yuan checks on the girl Xiaoyou’s recovery. Photographed by Zhang Guoguo
Xiaoyou’s mother recalled that at about two o’clock in the afternoon last Saturday (August 28), she discovered that her daughter’s left and right faces were asymmetrical, and the corners of her mouth were skewed to the right. His speech was slurred, only half of his body could move, and his left hand and foot were almost paralyzed. Realizing something was wrong, her mother rushed Xiaoyou to Wuhan Children's Hospital.
"The symptoms are wrong, like acute hemiplegia." Zhu Hongmin, deputy chief physician of the Department of Neurology of the hospital, first suspected a stroke (commonly known as "stroke") after receiving the diagnosis. Physical examination showed that the muscle strength of the left upper limb was only grade 0, and the muscle strength of the left lower limb was grade 2. In other words, compared with the normal level 5, Xiaoyou's left upper limb cannot move at all, and his left lower limb cannot be lifted off the bed.
Multi-disciplinary relay scrambles for treatment "window period"
"It may be acute cerebral hemorrhage, or it may be acute cerebral infarction, and rescue must be carried out as soon as possible." After receiving the "early warning" from Dr. Zhu Hongmin, the hospital immediately activated the green channel, CT/MRI imaging The Diagnostic Department has opened a fast examination channel. Feng Yuan, chief resident of the Department of Neurology, accompanied Xiaoyou throughout the examination, and the team of the Interventional Radiology Department was ready for surgery.
Based on the diagnosis of head CT examination and magnetic resonance imaging, it was considered to be acute cerebral infarction. There were infarction signal foci on both sides of the brain, and the infarct area was larger on the right side. In case of cerebral ischemia, if interventional thrombolysis surgery is not performed as soon as possible to clear the blocked blood vessels, it will be difficult for the brain tissue to recover, and the patient may be left with the sequelae of hemiplegia, or even be unable to walk for life.
The situation was urgent. My mother was in a panic and could not make a decision. After my father, who was far away in Xianning, learned about the situation, he decisively decided to operate immediately.
The interventional radiology team performed the interventional thrombolysis surgery and took photos of Zhang Guo
All the preoperative results were completed. At about 8 o'clock that night, Huang Sui, chief physician of the interventional radiology department, Dr. Liu Xinxian, Dr. He Xiaojun, as well as the anesthesia and nursing teams were all in place to immediately perform the surgery on Xiaoyou. Interventional surgery. A needle is inserted from the thigh and femoral artery, and a catheter with a diameter of less than 2 mm is sent all the way to the internal carotid artery, reaching the proximal end of the stenotic blood vessel in the child's brain, and releasing thrombolytic drugs. During the process of thrombolysis, some of the blocked blood vessels in the distal part of the brain are "opened".
Due to the timely intervention of thrombolytic surgery, the cerebral blood vessel "channel" was opened. The day after the operation, Xiaoyou's symptoms of skewed corners of the mouth disappeared. He could hold his left hand, lift his legs, and get out of bed to walk. His limb muscle strength recovered. to close to level 5. At present, the blood supply to Xiaoyou's brain has been restored, and some of the brain cells that were "on the verge of death" have also been saved.
Children's "stroke" is hidden, parents should identify it in time
Why does Xiaoyou suffer a sudden "stroke" at such a young age? Dr. Feng Yuan from the Department of Neurology said that during a cerebral angiography examination, it was found that there was thrombosis in Xiaoyou's intracranial arteries, which caused the narrowing of the blood vessels and caused a "stroke". However, the cause of thrombosis is not yet clear, and it may be related to Xiaoyou's primary disease.
Feng Yuan said that cerebral infarction in children is different from adults in that it is more hidden and relatively rare. The most common risk factors include: intracranial vascular malformation, history of congenital heart disease or cardiac surgery, vasculitis, thrombophilia, etc.How to identify
parents? Doctors remind that the symptoms and manifestations of "stroke" in children are similar to those of the elderly, including symptoms such as hemiplegia or facial paralysis, drooling, difficulty swallowing, choking on drinking water, speech impairment, and visual impairment. In severe cases, there may be loss of consciousness or breathing problems. , cardiac arrest, life-threatening. Therefore, once parents find that their children have symptoms such as weakness in hands and feet, listlessness, crooked corners of the mouth, slurred speech, and convulsions, they should not observe them at home. They should seek medical treatment as soon as possible to seek treatment opportunities to avoid lifelong sequelae such as hemiplegia and aphasia.
At present, thrombolysis is the treatment method most likely to improve the prognosis of cerebral infarction in the early stage. Within 6 hours is the "golden window period" for arterial interventional thrombolysis treatment. One minute of early treatment can reduce the death of nerve cells and the effect of treatment is The better.
Correspondent: Xue Yuan Photography Zhang Guozu
