What is Nerve Damage?
This includes:
Nerve injury
- Cerebral nerve injury includes the sequelae of brain trauma, cerebral vascular sclerosis (cerebral hemorrhage, cerebral thrombosis), encephalitis and meningitis sequelae, and demyelinating diseases.
Classification of Nerve Injury
- This includes:
- (1) The olfactory nerve injury is often manifested by ethmoid fracture or frontal brain contusion, such as cerebrospinal fluid leakage, partial or complete loss of one or both olfactory senses.
- (2) Optic nerve injury is often accompanied by anterior and middle cranial fossa fractures involving the orbital apex and optic canal. After the injury, vision loss or even blindness occurs, the direct light reflection disappears, and the indirect light reflection is normal. If the visual intersection is damaged, binocular vision is impaired, and the visual field is impaired.
- (3) Eye movement, tackle, abduction, and trigeminal eye branch injuries often show sphenoid winglets, temporal bone rock and maxillofacial fractures. Ocular nerve injury can see diplopia, drooping of the eyelid, dilated pupils, disappearance of light reflection, and the eyeballs deviate outward and downward; traumatic nerve injury can be seen with diplopia when staring downwards; abductor nerve injury can cause damage to the side eye Restricted, oblique eyeballs; trigeminal nerve injury showed disappeared corneal reflexes, facial sensory disturbances, weak chewing, and occasionally trigeminal neuralgia.
- (4) Facial and auditory nerve injuries often include fractures of the temporal bone and foramen. At different times after the injury, facial paralysis, loss of taste on the ipsilateral tongue 2-3, keratitis, tinnitus, vertigo, and neurological deafness are manifested.
- (5) Glossopharyngeal, vagus, para, and hypoglossal nerve injuries rarely occur. Frequent occipital fractures. Difficulty swallowing, loss of pharyngeal reflexes, loss of one third of the taste behind the tongue, hoarseness, drooping shoulders, atrophy of the injured tongue muscle, and tongue extension to the affected side.
Diagnosis of nerve injury
- (1) X-ray skull slice, skull base tomography, CT scan to infer cerebral nerve injury through the fracture line direction; (2) MRI thin scan of the skull base shows nerve root swelling, bleeding, and rupture;
- (3) Electrophysiological examination of evoked potentials can detect optic nerve and auditory nerve damage;
- (4) Electromyographic examination can determine facial nerve injury and judge prognosis.
Nerve injury disease treatment
Non-surgical treatment of nerve injury
- (1) Dehydration drugs relieve intracranial pressure and neuroedema. Intravenous infusion of 150% to 200ml of 20% mannitol is usually used, once or twice daily.
- (2) Glucocorticoid treatment protects the nerves. Dexamethasone 10 mg is usually given intravenously, 1 to 2 times a day.
- (3) Dilation of blood vessels and improvement of microcirculation drugs. Nimbrane is usually infused with 10 mg intravenously, once or twice a day. Low-molecular-weight dextran 500ml intravenous drip, 1-2 times a day.
- (4) Neuronutrition and metabolites are commonly used in energy mixtures, cerebrolysin, GM1, nerve growth factors and mimetics.
- Nerve injury
Nerve injury surgery
- (1) Indications for surgery: The fractured piece compresses the nerves of the brain. Intracranial pressure continued to increase, and the cranial nerve was squeezed. Non-surgical treatment is ineffective. Causes severe neurological irritation symptoms such as dizziness and neuralgia.
- (2) Preparing to identify the site of nerve injury through imaging, electrophysiology and clinical manifestations before surgery; choose neuromuscular for transplantation.
- (3) Surgery method Nerve decompression, intracranial or extracranial approach, to remove bone fragments that compress the nerve with a drill, to remove hematomas around the nerve, and cut off the outer nerve membrane, such as the optic nerve tube and facial nerve tube Decompression; Nerve reconstruction, including: direct reconstruction, such as direct nerve anastomosis, nerve transplantation anastomosis; indirect reconstruction, such as facial nerve-collateral nerve anastomosis; plastic surgery, such as mouth angle suspension surgery or temporal Muscle and masseter muscle transfer, etc .; Cerebral nerve destruction, such as selective trigeminal nerve roots for trigeminal neuralgia.
- (4) Postoperative management: Comprehensive recovery by combining drugs, physical therapy, and acupuncture
- Cauda equina injury
- Cauda equina syndrome is a difficult subject in the world. Clinically, spinal violent fractures, lumbar degenerative lesions, cholesteatoma of the cauda equina, schwannomas, spinal meningiomas, lipomas, or metastases stimulate the cauda equina nerve. At present, western medicine treatment is mainly based on surgical removal of vertebral bone fragments that protrude from compressed fractures in the spinal canal, prolapsed intervertebral discs, and tumors that stimulate the cauda equina, supplemented by dehydrating agents, corticosteroids, nutrients or free radical scavengers. Not ideal and has some limitations. Director Huo, an expert clinic of Henan traditional Chinese medicine, applied the theory of traditional Chinese medicine, and after nearly 20 years of clinical exploration, he used traditional Chinese medicine "Zhuyu Tongluo, nourishing the spleen and kidney, channeling water channels" therapy and traditional Chinese medicine "tumor elimination" method, in conjunction with traditional Chinese medicine "fascial shock" Better results have been achieved in the treatment of cauda equina infestation and sexual dysfunction, which further improves the clinical cure rate of cauda equina syndrome.