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约11％～25％小脑梗塞造成占位性改变,引起脑干受压和阻塞性脑积水,其后期死亡率高,手术治疗可改善预后,但有关手术时间、方法选择尚存争议。作者报告了52例占位性小脑梗塞的处理经验。 占位性小脑梗塞至少满足下列一项CT标准:四脑室移位;阻塞性脑积水和基底池部分或完全消失。本组病例不包括开始即有昏迷、偏瘫或四瘫的严重脑干梗塞,出现脑干受压征39例(75％),意识障碍41例(78.8％),昏迷19例(36.5％),无明显临床症状7例(13.5％)。多数病例于中风后3天出现脑干受压征及意识障碍。从开始出现脑干受压征或意识损害至昏迷或强直状态的间隔时间多数(14/19)不足24小时。手术治疗36例,其中单纯切
About 11% to 25% of cerebellar infarction caused by space-occupying changes, causing brainstem compression and obstructive hydrocephalus, the latter part of the mortality rate, surgical treatment can improve the prognosis, but the operation time, the method of choice is still controversial. The authors reported 52 cases of occupying cerebellar infarction experience. Occupy cerebellar infarction meets at least one of the following CT criteria: four-ventricle transposition; obstructive hydrocephalus and basal cistern partially or completely disappeared. This group of patients did not include the beginning of a serious cerebral infarction in coma, hemiplegia or quadriplegia, brain stem compression occurred in 39 cases (75%), disturbance of consciousness in 41 cases (78.8%), coma in 19 cases (36.5% No obvious clinical symptoms in 7 cases (13.5%). In most cases, brain stem compression and disturbance of consciousness occurred 3 days after stroke. The majority of intervals (14/19) from the onset of brainstem compression or unconsciousness to coma or straitness were less than 24 hours. Surgical treatment of 36 cases, including simple cut