Distance (Pursued Hot Duda)
40 Explanations from Doctors

"Can you heal, Doc?"

"How do I cure it?"

"It can be cured, if it is treated promptly. The doctor must perform a neurological examination and physical examination, by examining the brain function and level of consciousness of the patient, to detect pain, discomfort or abnormalities. Also do tests, such as blood tests, which serve to find out the cause of brain swelling. Scanning with CT Scan or MRI, to see the location and severity of brain swelling. Then lumbar puncture, to make sure if the brain swelling is caused by meningitis, encephalitis, subarachnoid hemorrhage or cancer. In mild conditions, such as altitude sickness, brain swelling can recover by itself within a few days."

"So what to do?"

"There are several commonly used methods to treat brain swelling, depending on the severity of the disease and how long the patient has been experiencing it, such as giving a special type of infusion to reduce swelling and lower pressure in the brain. Giving medication, also to reduce swelling and prevent blood clots. Installation of breathing apparatus, of course to help patients breathe, also to ensure that patients do not lack oxygen. Ventriculostomy, to remove excess fluid in the brain. The trick is to insert the tube through a small incision in the head, as a drain, to reduce ICP pressure. Osmotherapy, a procedure to remove water from the brain, is done using osmotic agents such as mannitol, or high salt. This osmotic therapy also helps in improving blood circulation, to be able to reduce swelling and ICP in the skull. It could also be with a controlled hyperventilation method, aimed at lowering ICP and lowering blood flow. It will make the patient exhale more than oxygen is inhaled, so carbon dioxide in the bloodstream can go down. So proper blood flow to the brain can be done by controlling carbon dioxide levels. Then surgery, if this swelling happens because of a tumor."

They hold their breath. Hand slashed knife alone is very sick, especially slashed head then inserted tube, although it does use anesthetic.

Erlang shook his head, unable to imagine Freya having to feel it.

"ICP is, what?"

"The buildup or increase in pressure of this fluid, often referred to as intracranial pressure or intracranial pressure (ICP). Increased ICP can lead to reduced blood flow and oxygen received by the brain."

"But, Doc, how could Freya have this brain swelling?"

"It could be due to several factors. Like viral infections, bacteria to parasites. Examples of diseases are meningitis (inflammation due to infection of the membranes that wrap the brain and spinal cord), brain abscess, encephalitis (inflammation of brain tissue), toxoplasmosis. It can also be called traumatic brain injury (TBI). Caused by a fall, traffic accident, hit, or hit the head something hard. External head injuries only injure the scalp, while internal injuries can involve the skull, blood vessels in the head and brain. Then stroke. Can be due to ischemic stroke, which is the type of stroke that most often causes swelling, caused by blockage of blood vessels in the brain. As a result, the brain cannot get a supply of blood containing enough oxygen, causing brain cells to mato and swelling occurs. Then the second hemorrhagic stroke, occurs when blood vessels in the brain rupture. It can also be caused by a tumor. Tumors that are getting bigger can press on the area of the brain around it. It can also block cerebrospinal fluid from flowing out of the brain, causing swelling. New blood vessels that grow in and around the tumor can also cause brain swelling. Treatment varies from patient to patient, depending on the type, size, location, health condition. It can also be caused by hydrocephalus and High Altitude Cerebral Edema (HACE). Cerebral palsy or cerebral palsy, a brain development disorder that can occur while still in the womb or after birth, which can affect the motor area of the brain and affect the level of intelligence. Epilepsy, and psychiatric illness. Some psychiatric illnesses are associated with anatomical abnormalities or impaired chemical function in the brain. Brain twitches as well as drug use or the influence of alcoholic beverages can cause this condition. Brain bleeding, which occurs when blood vessels in the brain rupture and leak, leading to inflammation and an increase in ICP."

The doctor was silent for a moment, then continued the explanation.

"Hydrocephalus occurs due to blockage in the flow of brain fluid, impaired absorption of brain fluid, or due to excessive production of brain fluid, eventually fluid accumulates in the brain and causes swelling. While HACE experienced in mountain climbers at 2,500-4,000 meters."

"So, you may have misdiagnosed, maybe not brain swelling."

They still don't accept this.

"What are the symptoms, Doc?"

"Of course, each patient experiences different symptoms, depending on the cause and severity. Such as headaches, pain and stiffness in the neck, dizziness, nausea, vomiting, disturbances in movement, numbness, irregular breathing, vision becomes blurred. Then in the advanced stage, namely fever with a temperature of more than 38.3 degrees Celsius, decreased level of consciousness, memory loss, mood changes and sudden behavior such as confusion, delirium, lethargy, hallucinations, delusions, and, aggression (behaving violently), being unable to speak clearly, being paralyzed or unable to move a limb, intestinal obstruction, urinary incontinence, severe headaches, seizures. For that, this should be discussed with the patient or see the results of the patient's previous medical records. Hmm, are there any symptoms in it that have ever been felt by Miss Freya."

"He had passed out, but it was in Durham."

"He's been in an accident before, Doc. But it was a long time ago. About nine years old, at that time he was still in sixth grade. It couldn't have been because of the accident, could it, Doc? It's been a long time, why is it only now that the impact is felt?"

"Then, what else happened?"

"Hm, as a result of the accident, he fell into a coma for several months. We were still in Singapore then we moved the treatment to Germany."

"I had to consult him first with his doctors in Singapore, Germany and Durham. I had to see the results of the examination at that time, whether something was missed, or indeed this swelling had just occurred. Was that the only time that Miss Freya fainted?"

"No!" zilda replied suddenly, as she remembered something.

"What's happened before."

"Sast High School, he had a headache to scream hysterically, but the next morning he seemed to forget and not feel pain anymore. You guys remember, right? Sast at the villa first?"

The memory of some people is now back to the days of Freya undergoing drug therapy.

"He ... He also passed out. Nuna, you used to be with Freya, right, when she passed out in the tea garden. What really happened back then?"

"I don't know either. When Arby said he wanted to go to the toilet, I went for a walk myself. Suddenly I saw Freya who was already on the rocks and unconscious. I don't know if she fell from stumbling and fainting, or how, when I wanted to ask for help, Nania and Aruna came first."