Biological clock question: Hello Professor Li, a patient admitted some time ago has been uploaded to the forum. A few questions: 1. Is viral or bacterial infection more likely to be considered in this patient? 2. Prof. Li Xiaoyong: I don’t know if this patient had a cold-like episode before this attack, but because of the symptoms of fever, vomiting and neck resistance. From the cerebrospinal fluid tests, it definitely has the manifestation of cerebrospinal fluid infection. As for the precise diagnosis of sick brain or chemical brain, from the general clinical hospital or even I do not have the exact certainty. But within the current scientific stage, the first consideration should be treatment: humans still do not actually have a substantially effective treatment for viruses, and most have a self-limiting process; while bacterial infections are mostly continue to worsen, and there are currently treatments available. You are interested in finding the cause of the high percentage of mononuclear cells, but according to my experience over the years, there are still many unresolved problems in the diagnosis of cerebrospinal fluid cytology, and it is not uncommon to see incorrect diagnoses in the clinic, so it is more appropriate to combine clinical analysis. If you have to go deeper into this problem, more basic scientific research is needed, and this patient only has these few reference indicators, which cannot be answered accurately by you. It is true that there is now a clinical over-reliance on cerebrospinal fluid cytology for diagnosis, which is actually not clinically meaningful and often delays proper treatment. You can take a look at case #31 in the classic cases on the Cerebrospinal Fluid Neurosurgery website. This child is a case similar to the one you mentioned: Beijing Children’s Hospital and Beijing Union Hospital had repeatedly and repeatedly diagnosed meningeal cancer based on cerebrospinal fluid cytology, and until after he was completely cured and discharged from our hospital, these two hospitals still persistently and responsibly tracked and warned the family that the child was meningeal cancer because the most authoritative cerebrospinal fluid cytology diagnostic units and experts made this diagnosis. The child has now been discharged from the hospital for almost 2 years and everything is back to normal. The actual results are the best way to test the diagnosis, so the cerebrospinal fluid cytology diagnosis needs to be studied in more depth and is still imperfect in terms of infecting the causative organism. Prof. Li Xiaoyong: How to deal with a hydrocephalus patient with intracranial infection and repeated blockage of lumbar pool drainage? Prof. Li Xiaoyong: In the case of hydrocephalus combined with intracranial infection, when you encounter repeated blockage of lumbar pool drainage, you should know that the infection has become serious, especially when the first blockage should be realized that the problem has become serious, and repeatedly continuing lumbar pool drainage by changing the site again should be considered extremely wrong treatment, because at this time lumbar pool drainage is not a treatment but a way to aggravate the infection. If you encounter this situation, it is recommended that you immediately refer the patient to a hospital that specializes in the treatment of this disease, otherwise there may be irreversible results.