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Editor's note: May 9 (Thursday) 14:30-15:30 pm, neurosurgery leader, Beijing Tiantan Hospital Vice President Zhang Wei as a guest "people's good doctor" client, for 100,000 netizens popular brain tumor knowledge, and answer a group of netizens' disease questions.
Zhang Wei, Chief Physician, Vice President of Tiantan Hospital, Beijing. Deputy Director of the National Center for Clinical Medicine of Neurological Diseases and President of the Neurosurgeon Branch of the Chinese Physicians Association. A leader in neurosurgery, the world's first to discover "brain stem glioma-specific PPM1D gene functional acquired mutation", known as "the world's neurosurgery field on the most important findings of brain stem tumors"; A variety of cranial brain stem surgery into the road, integrated nerve function protection multi-modal technology, applied to the brain stem and cranial complex tumor comprehensive diagnosis and treatment
, significantly improve the patient's prognosis; Are there any typical symptoms?Vice President
Zhang Wei: This is also the knowledge we have been in science, I hope to make more people know on this platform. Headaches and headaches accompanied by nausea, vomiting and other symptoms, many people will think of checking the brain, because these are the symptoms that can make people "associate" to the brain or head, there are some symptoms of brain tumors, easily ignored by patients or even misdiagnosed by doctors in other areas, this is vision changes, such as reduced vision, narrow vision and even even See the ghosts of things; hearing changes, such as sudden deafness, neurodeafness, tinnitus and hearing loss; changes in female endocrine, such as sudden amenorrhea of young women; numbness of walking legs and feet, half-face tint, even coughing, hoarse, shruging, sleeping snoring... These symptoms, which appear to be difficult to link to brain tumors, may in fact be some clinical manifestations of brain tumors. The symptoms caused by brain tumours are rarely alleviated naturally, and they tend to persist or even worsen. The appearance of suspected brain tumor symptoms, should go to neurosurgery as early as possible, do a cranial imaging examination, such as magnetic resonance, that is, can let the doctor have a judgment.
asked: Dean, do you have a very impressive case, why?Vice President
Zhang Wei: I am doing craniofacial and brain stem tumor surgery, this area of tumors in particular brain stem tumor is very dangerous, because the brain stem controls the body's breathing, heartbeat and consciousness of the three most basic life activities. The cranial tumor is often closely related to the brain stem. I've been a brain surgeon for more than 30 years and I've really been dealing with these dangerously abnormal tumors. One of the most impressive cases was a 27-year-old woman with a brain stem tumor at the bottom of her skull, and we had surgery from morning until 2 a.m. the next day. Why has it taken so long? Because the patient is very young, we want to protect her body nerve function, so that she can live as normal as possible after surgery, so we want to and blood vessels, nerves closely wrapped in the tumor, a little peel, a little bit of the tumor cut off. Instead of three down five divided by two, simply everything. It is necessary to remove the tumor as much as possible, avoid the recurrence of the tumor, but also to retain the normal physiological function of the patient as much as possible, which requires a lot of fine work. I was the next morning under the operating table, seven o'clock to the hospital, to see the patient has awakened, no coma, function, physical activity are not affected, really very happy!
: My mother had a meningioma operation in 2014, when she was 51 years old and had the brain tumor removed. After the operation is also very good, thank you very much. This live broadcast has a few questions to consult you again: 1, the operation of the large tumor successfully peeled off, but there is also a small tumor in the main blood vessel, due to the higher risk did not cut. This year's film review shows that the brain has some fluid, do not know whether there is an impact, is it necessary to go to the hospital to do some more examination?2, the mother occasionally after surgery there will be some more serious headache, left ear deafness, left eye squint, etc. have not improved, this has no other way?
"How to maintain balance in tumor full-cutting and retention function" is the most critical part of brain surgery. Many brain tumors are around the patient's blood vessels, nerve growth, to the doctor to bring technical challenges, but also test the doctor's choice - whether the tumor cut the cleaner the better, if cut thoroughly but affect the quality of life of patients how to do? Mature brain surgeons must balance the relationship between the two. You said the mother's mother's brain left the tumor, must be very tight with the very important blood vessels, forced peeling may lead to bleeding blood vessels, cerebral infarction or dysfunction, etc. , should be left according to the actual situation at that time. But don't worry, this small tumor should also have been treated. Tumor growth needs nutrition, the tumor's nutritional supply that is the blood transport should be broken, so that it will not change much in the future. This is the first.
second, about the fluid after the tumor is removed. Adult brain tumors will generally grow larger, after cutting there will be a residual cavity, brain tumorgrowth in the skull, which is also medically called tumor occupatic effect. The remaining space after the tumor is removed can only be the water in the brain, the cerebrospinal fluid to fill in. Also do a check to see if the cerebrospinal fluid is compressed brain, there is no need to deal with.The third
is the issue of functional recovery. My advice to patients with brain tumours has always been to "start recovering as soon as possible." Recovery from brain tumors is important, but it can take a long time. Some patients need to recover, but after a month or two of finding it ineffective, they give up. But the restoration of nerve function is the need for persistence and endurance, medically there are still cases of the number of plants sober, is the best interpretation of persisting in recovery. Patients are advised to have another functional exercise.
ask: Is it easier to get a glioma when you play with your cell phone for a long time and sleep next to your cell phone?Vice President
Zhang Wei: This issue has been widely concerned in the academic community, discussed for more than ten years, we are also very concerned about this issue. Mobile phones are now increasingly used in everyone's life, have become a part of life, and some even call them "partners", to make it clear that
phones may be a very important risk factor for brain tumours. But this is not to say that "mobile phones are bound to cause brain tumors", the results of the current study do not have such a clear conclusion.
: My son is 17 months old, the left side of the brain has a tumor, the left side of the top tube membrane tumor three. On March 29 this year in a hospital in the south successfully removed, a month after surgery in good mental state, would like to ask President Zhang: the child will start chemotherapy this week, there is no better treatment than chemotherapy, chemotherapy can extend the survival? How to do a good job of further recurrence, how to supplement nutrition, prevent infection?
, Zhang Wei Vice President: ventricular membrane tumor three, the degree of malignancy is still relatively high. For small patients who are ten months old, treatment at home and abroad is not recommended for radiotherapy, and chemotherapy can be used in the next treatment after surgery. For chemotherapy, the whole body changes, such as bone marrow inhibition, should be closely observed, and do not over-use some so-called special treatments. Because a ten-month-old child, his immunity is not good enough. Overtreatment can inhibit your child's immunity and lead to tumor recurrence. At this time should be closely observed, stable and effective treatment.
Is there any better treatment? Can understand the current immunotherapy, gene therapy, as well as targeted therapy, many treatments in China is still in the clinical trial stage, but you can try to join the group in clinical research in Chinese medicine treatment is also a direction. (Editing
based on video) .