The woman, who was in her 30s, was in good health, but when she was 27 weeks pregnant with her second child, she had a sudden massive cerebellar hemorrhage followed by brain herniation, and after an emergency craniotomy by Prof. Chao Yang at Zhongshan First Hospital, it took 12 hours to successfully save the mother and the fetus. Three resuscitations and two surgeries within a week, in retrospect, was such a thrilling scene. It has become a question for many people as to why a pregnant woman would have a sudden brain hemorrhage. It is known that the chance of stroke in pregnancy is about 32/100,000, and gestational hypertension syndrome (hyperemesis gravidarum) is the most common cause of brain hemorrhage in pregnant women. However, Dr. Yang Chao, associate professor of neurosurgery of Zhongshan First Hospital, who was in charge of the rescue of the pregnant woman, said that more than 95% of cerebral hemorrhage caused by hyperemesis occurs in the brain, but the bleeding site of the pregnant woman was in the cerebellum, and there was no history of hyperemesis, so the possibility of rupture and bleeding from cerebrovascular malformation was highly suspected. Cerebrovascular malformation, usually congenital, is usually asymptomatic, but once it ruptures and bleeds, it is very critical. In fact, in addition to cerebrovascular malformations, there are many neurosurgical diseases that have no symptoms or atypical symptoms in the early stage, so they are often easily missed or misdiagnosed, such as the following cases: dementia in the elderly may be caused by hydrocephalus Many elderly people, as they grow older, experience symptoms such as memory loss, slower walking, and in some cases, urinary incontinence. Many family members mistakenly believe that this is the reason for getting older and is a normal phenomenon. In fact, these may be signs of dementia, and many people think that dementia is incurable, so they don’t go to the doctor, but this is not true. In fact, not all elderly people with dementia have Amtsheimer’s disease, some suffer from vascular dementia, and some patients have hydrocephalus. The incidence of this part is relatively low, but due to the increasing proportion of elderly people in China, the incidence is also increasing. But most people will ignore this, so the possibility of missing the diagnosis is relatively high. Yang Chao reminded, “Dementia in the elderly caused by hydrocephalus is potentially curable. By introducing excess cerebrospinal fluid into the abdominal cavity through ventriculoperitoneal shunt surgery, the surgery can significantly improve the patient’s responsiveness, memory and motor function, and dementia can be significantly improved or even cured.” As for how to know if it’s caused by hydrocephalus, you can usually find out with an MRI. Numbness in the fingers: Beware of Arnold-Chiari malformation. When there is numbness in the shoulders, which extends to the arms and even the fingers, many people will think that it may be caused by cervical spondylosis; when they go to the hospital, the doctor will usually recommend a CT examination; if the CT shows normal, perhaps some people will choose to take some medicine and observe first, but if there is still no improvement after six months. MRI, which has a higher resolution than CT, can clearly show the state of the spinal cord. Yang Chao especially reminded that “the appearance of asymmetric finger numbness, especially single finger numbness gradually spread to other fingers, should remain vigilant and should see neurological surgery as soon as possible.” He introduced, “Finger palsy in both hands may be caused by medical diseases such as diabetes, but asymmetric finger numbness may be caused by cervical medullary diseases, such as spinal cord cavitation caused by an Azi malformation.” Arnold-Chiari malformation, also known as subungual herniation of the cerebellum, can be treated surgically and the earlier it is detected, the more likely it is to be cured. Tails on the buttocks should not be taken lightly When a baby is born with a “tail”, a subcutaneous mass, hair, or a small pit or fossa in the midline of the buttocks, parents usually go to pediatric surgery, and some doctors will just cut it off as a lipoma. But in fact, “tail on the buttocks” is definitely not a small thing, a large possibility of spinal cord embolism. Yang Chao pointed out that if the spinal cord embolism is not treated in time, the child will grow up with lower limb pain, lameness, scoliosis, urinary and fecal difficulties and even renal insufficiency, called “spinal cord embolism syndrome”; however, through surgery, blocking the spinal cord continues to be stretched, you can preserve neurological function and prevent the disease from continuing to progress.