I. Disease introduction
1.Intracranial arteriovenous malformation is a congenital vascular anomaly, mainly manifested as direct communication between arteries and veins. Most of the clinical symptoms are epilepsy, subarachnoid hemorrhage and severe headache. If there is hematoma formation, hemiparesis, aphasia and increased intracranial pressure may occur.
2. Aneurysm is an abnormal bulging part of the intracranial arterial wall, mainly associated with congenital defects. It is mainly related to atherosclerosis, hypertension, infection and trauma.
3.The onset of aneurysm is rapid, often accompanied by severe headache and vomiting, mostly with signs of meningeal irritation.
4.DSA can clarify the site and nature of intracranial arteriovenous malformation and aneurysm.
5.Surgery is the fundamental treatment for intracranial arteriovenous malformation and aneurysm.
Psychological guidance
1.Avoid emotional excitement, because sympathetic excitement causes small artery spasm, resulting in increased blood pressure, which can trigger cerebral hemorrhage.
2, maintain a good state of mind, listen to light music, learn deep breathing and other relaxation techniques.
3.When the patient is well discharged from the hospital, it should be clearly explained to the patient and family members that discharge is not equal to complete recovery, and that rehabilitation should be carried out throughout in order to maximize the residual function.
4, rehabilitation training, especially walking training, the patient should not be overconfident, do not stand up and move the body unaccompanied, to avoid accidents such as falls.
5. Rehabilitation training should be evaluated regularly to understand the patient’s rehabilitation progress and modify the training plan in time. Tell the patient not to be irritated by certain repeated examinations and to try to cooperate.
III. Dietary guidance
1. A light, high-protein, high-calorie, easy-to-digest, low-fat diet is recommended.
2, eat more coarse fiber food, keep the bowel movement smooth.
3. Quit smoking and drinking, forbid spicy, cold and other stimulating foods and excitatory drinks.
4.Fast for 8-10 hours before surgery, and forbid drinking for 6-8 hours.
5. 6 hours after awakening from anesthesia, a small amount of liquid diet may be allowed without swallowing disorder, and then gradually changed to soft food.
IV. Pre-operative guidance
1. Pay attention to keeping warm and preventing colds one week before surgery.
2.Prior to surgery, you should actively train coughing and sputum excretion.
3.Please start to practice urination in bed from 3 days before surgery, at least twice a day.
4.Please cut your finger (toe) nails short and pay attention to keep your body clean.
5.Please ensure sufficient sleep before surgery. If you have insomnia, please inform the medical staff and take oral medication to induce sleep.
V. Postoperative guidance
1.Eating should be allowed only after 6 hours of anesthesia wakefulness.
2.After waking up, if the blood pressure is stable, elevate the head of the bed 15-30 degrees to facilitate intracranial venous reflux.
3.Remove oral and nasal secretions in a timely manner, keep the respiratory tract unobstructed, and encourage the patient to cough up sputum.
4. Keep quiet and avoid emotional excitement.
VI. Discharge instruction
1.Rational nutrition, keep the stool unobstructed; diet should be light, easy to digest and rich in crude fiber to prevent constipation.
2. Patients with high blood pressure should adhere to the medication under the guidance of the doctor. Do not change the dosage or stop taking drugs at will, so as not to increase blood pressure and induce bleeding.
3. Rehabilitation treatment.
(1) Hemiplegia.
①Take drugs conducive to tissue repair under the guidance of the doctor, together with hyperbaric oxygen, physiotherapy and acupuncture treatment, in order to promote the recovery of brain function.
(2) Massage the paralyzed limb 6 to 10 times/day regularly to promote local blood circulation.
③Perform passive exercise of the paralyzed limb and active exercise of the healthy limb to prevent muscle atrophy.
④ Maintain the functional position of the limb. Use “L” splint to fix the ankle joint to prevent foot drop.
(2) Pronunciation instruction for aphasics.
①Start from pronouncing monotone and gradually move to teaching the patient to speak everyday words to train motor language function.
(2) Use the form of listening to radio and broadcasting to let the patient listen to familiar songs and favorite programs in the past to train the patient’s auditory language function.
③Train patients’ visual language function by teaching them to recognize their own names and simple word symbols.
(3) Secondary epilepsy: not to go out alone, not to climb high, ride a bicycle, swim, etc., carry a certificate of illness with you, and insist on taking anti-epileptic drugs for 3 to 5 years.