sunhongwei0451 ： Ask @Professor Li Xiaoyong: Is it possible to replace the cerebrospinal fluid in the brain? Prof. Li Xiaoyong : I don’t know what kind of replacement you are talking about here?
Is it possible to replace the cerebrospinal fluid of a chemocephalic patient with saline or artificial cerebrospinal fluid? I think this method is useless for intracranial infection control because the principle of treatment is wrong: can bacteria be replaced out of the cerebrospinal fluid or out of the patient’s body by replacement? Infected bacteria, which grow and multiply in the brain tissue or brain parenchyma, cannot be eliminated by simple cerebrospinal fluid replacement without antibacterial drugs. wuhan309 ：A question to @Prof. Li Xiaoyong: Prof. Li, what is the proper treatment for aseptic meningitis secondary to craniopharyngioma surgery? Is there a formal treatment guideline? Prof. Li Xiaoyong ：
There are two types of aseptic meningitis: one is without hydrocephalus, and the other is with hydrocephalus. The former does not require any special treatment and will disappear naturally after the acute phase. In the latter case, the hydrocephalus needs to be treated at the same time, and a ventriculoperitoneal shunt should be performed when the cerebrospinal fluid is normal. A special attention should be paid to: pseudo-sterile meningitis. In our experience, those with more severe clinical symptoms are actually bacterial meningitis. Still, it is important to note the fact that: cerebrospinal fluid without bacterial culture cannot be fully identified as aseptic meningitis. As you said, there are no treatment guidelines in this area, and it needs to be researched and summarized by future generations. 流云陵枫 ：向@李小勇教授提問：Li, how long after craniotomy can the cerebrospinal fluid cell count return to normal, and how can intracranial infections be identified early after craniotomy from cerebrospinal fluid biochemistry, etc.? Prof. Li Xiaoyong
First of all, I don’t know why you opened the skull? Is the preoperative intracranial area non-infected or infected? What is the extent of damage to intracranial structures during surgery? In addition, what kind of cerebrospinal fluid cells are you talking about, inflammatory or non-inflammatory cells? I’m going to assume you are talking about cerebrospinal fluid cells from an intracranial infection. Infection-associated cells in the cerebrospinal fluid are negatively correlated with the degree of infection control, and there should be no cells in the normal clinical test results of the cerebrospinal fluid. Also if there is no intracranial infection or hydrocephalus, you don’t have to be concerned about the cells in the cerebrospinal fluid. If there is a combination of hydrocephalus, you should treat the cells in the cerebrospinal fluid to a normal level where there are none, but clinically there are actually cells in the cerebrospinal fluid, and as long as they are not infectious, they should be normal. But how can you determine if the ones in the cerebrospinal are infected or non-infected cells? There is really almost no reliable method, and even if there is, it is often unreliable, so it can be inferred more accurately based on extensive clinical experience, but it is not the most accurate. The longer the normal time, the more accurate the judgment. luoqiboy ：A question to @Prof. Li Xiaoyong：Hello Professor Li, is hydrocephalus shunt infection an intracranial infection? Prof. Li Xiaoyong ：
Internationally, many people define hydrocephalus shunt infection as basically the same as cerebrospinal fluid infection, which is a kind of central nervous system infection. According to my many years of clinical experience with cerebrospinal fluid shunt infections, they can be classified as follows according to the site of infection: 1 shunt intracranial infections, 2 infections in surgical wounds or subcutaneous tissues where shunts travel, and 3 infections at the endpoint of cerebrospinal fluid shunts: abdominal, thoracic, intravascular or blood, urinary system. Cerebrospinal fluid is a mediator of infection transmission, and because of the presence of shunts, infections can occur in other parts of the body that come in contact with cerebrospinal fluid. In this way, shunt infections are not only intracranial only, but often occur extracranially as well. Special attention should be paid to the transmission of infection through the cerebrospinal fluid in the shunt in two directions: one is from intracranial to extracranial development of infection, and the other is from extracranial, such as abdominal and thoracic, blood development to intracranial.