In the outpatient clinic, there are always some family members who cannot listen to the doctor’s advice rationally, always worrying about the risk of surgery, hoping that conservative treatment can produce unexpected miracles, and delaying the surgery time again and again, and then coming to the doctor when the disease is terminal and can no longer be delayed, at this time, the risk of surgery is greatly increased, and irreversible damage to brain function occurs, which the family regrets, and in fact, in the end, the patient is put in a more dangerous situation. The family regrets that in the end, the patient is put in a more dangerous situation. Etiology of smog: The exact cause of smog is still unclear. For those who know the cause, such as some atherosclerosis and intracranial vascular disease caused by leptospirosis, it can also cause smoke-like changes in blood vessels on angiography images, and this kind of known cause is called smog syndrome, but it is also commonly called “smog state”, such as in the United States. The essence of the lesion: smog is a chronic progressive occlusive disease of the cerebral blood vessels of unknown origin. For example, the neurons in our brain, which are responsible for various functions, are like crops in the field, the glial tissue is like the soil, and the cerebral blood vessels are like the irrigation channels. Under normal circumstances, the brain is well irrigated and the crops grow lushly. If the irrigation channels gradually blocked, then it will cause drought, the brain on the “drought”, the crops will be dehydrated, gradually withered yellow (ischemia), and even in severe cases directly withered (infarction), this is the process of smog caused by cerebral ischemia and cerebral infarction. But our brain is very “smart”, when the main channel is blocked, it will automatically open some small “secondary channels” to relieve the “drought” downstream as much as possible, these secondary channels are what we see in the angiogram These are the “smoky vessels” we see in angiography. However, these smoke-like vessels are not original, and their walls are very thin and prone to rupture and bleeding. Once they rupture and bleed, they can cause “flooding” in the brain, which can drown crops and affect neurological function. So smog can cause both cerebral ischemia (drought) and cerebral hemorrhage (flooding). With the development of medical technology, the diagnosis and treatment of smog is no longer a problem, and surgery is generally safe if adequate preoperative preparation is done. For patients with smog, early detection and diagnosis as well as early treatment is the key. Most of the patients can return to normal life through surgical treatment in 90% of the cases after scientific and correct diagnosis and timely surgery.
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