Chapter 1547: Chapter 627: The Three Major Sequelae of Thalamic Hemorrhage and the Compassion of Healers

After viewing the brain CT scan, Zhou Can’s expression instantly became exceptionally serious.

The patient’s condition is more severe than imagined.

Shadows can be seen in the thalamus and caudate nucleus, and there’s even a slight water shed visible. This indicates that the hemorrhage is located in the thalamus, and the volume of bleeding certainly exceeds 5ml.

Intracranial hemorrhage is classified into two situations: one in the cerebral layer, such as the brain’s gyri and sulci, where even if bleeding exceeds 5ml it might not be serious. As long as the bleeding can be controlled, surgery is usually unnecessary, and the patient can absorb the bleeding on their own and then recover.

In fact, in neurosurgery, there are occasionally encounters with special patients, such as those with malignant tumors or accidental injuries, ultimately leading to nearly one-fifth or more of the patient’s brain being resected.

However, the patient can eventually survive and be able to take care of themselves.

Thus, the location of brain hemorrhage determines whether it is high-risk.

The hemorrhage in this patient’s case is located in the thalamus, and what worries Zhou Can most is the possibility of hemorrhage in the brainstem as well.

Many people think that the thalamus is the brainstem, but it is not.

It is part of the diencephalon, divided into two parts on either side of the third ventricle, connected by a mass of gray matter.

Medically, the thalamus is considered the sensory relay center, with neural impulses from sensory receptors throughout the body relayed to the cerebral cortex via the thalamus.

Zhou Can had just reviewed the patient’s condition and found she did not respond when called, was unconscious, and was in a deep coma.

This is also his greatest worry.

Thalamic hemorrhage can lead to severe bodily issues, but this patient is in a deep coma and exhibits respiratory and cardiac failure symptoms, raising suspicions that bleeding might not be confined to the thalamus.

Zhou Can may not be very skilled in the neurosurgical field, but he knows a lot more than the average neurosurgeon.

After all, during his neurosurgical training, he studied under a chief physician and personally participated in many major intracranial surgeries. His insights and experience are notable.

After completing neurosurgical training, he was frequently invited by neurosurgery to assist in intracranial endoscopic surgeries or diagnose complex cases.

Even Wu Baihe discussed with him multiple times.

Thus, his neurosurgical skills are not lacking.

The impact of thalamic hemorrhage should be analyzed from its three major complications.

First are the physical symptoms: the patient will experience severe and distinct headaches. Typically, few people’s bodies can withstand such pain, resulting in gastrointestinal symptoms.

Such as nausea and vomiting, among others.

Some may experience paralysis or weakness on one side of the body.

If limb paralysis occurs, it indicates that the patient’s thalamic hemorrhage is quite severe.

This is a bad sign, and the prognosis is often poor.

The second major complication is sensory disturbance.

The thalamus acts as a relay station for transmitting neural signals from the brain’s central and sensory organs throughout the body to the cerebral cortex.

Neural signals from the brain’s central and sensory organs are relayed by the thalamus, then transmitted to the cerebral cortex.

This shows that the thalamus plays an extremely important role in processing sensory neural signals throughout the body.

When it has issues, it will have disastrous consequences for the central nervous system and brain.

Take building a large dam, for example.

If the surging floodwater directly hits the dam, it can easily collapse. Hence, smart engineers designed a backwater area to buffer the impact and reduce stress on the dam.

Thereby greatly enhancing the safety performance of the dam.

The largest dam built by a third party was destroyed by flood on its completion day, not only due to corruption-related quality issues but also because some key technologies were not mastered.

The thalamus acts as both a translator and a buffer center.

When it has problems, patients might experience decreased sensation or even a loss thereof. The most common is numbness, where part of the body loses or significantly decreases its sense of pain.

Recently, many who contracted COVID-19 experienced loss of taste and smell, possibly due to an impact on the thalamus.

If there’s an issue with the thalamus, you may not perceive unpleasant odors that we normally find intolerable.

Or only smell them slightly.

Of course, smell is related to the nose and internal olfactory structures and organs.

This requires comprehensive differential diagnosis; olfactory loss isn’t automatically presumed to be due to thalamic problems.

The third complication is consciousness disorder.

Almost any intracranial tissue trauma or issue might lead to consciousness disturbances.

Some tissues can’t directly cause consciousness disturbances, but can indirectly affect it.

For instance, hematomas can directly compress the cranial cavity, or significantly increase intracranial pressure, among other things.

When thalamic issues arise, common consciousness disorders include drowsiness, hallucination, confusion, stupor, etc. In severe cases, coma can occur, although it’s quite rare clinically.

The more common symptoms are decreased consciousness level, becoming lethargic or ’psychotic’, with full consciousness loss sometimes possible.

After analyzing the three major complications resulting from thalamic damage, you can retrospectively infer the affected area based on patient symptoms.

This is why Zhou Can feels the condition is more severe than imagined.

The first situation, if the thalamus leads to the patient’s deep coma, indicates the patient’s thalamus is severely damaged.

The second situation, if it’s not the thalamus causing the deep coma, then it is likely that there is also bleeding in the brainstem.