论文部分内容阅读
脑转移癌发生瘤体卒中较多见,但术后误诊脑梗塞少见,笔者遇到2例,现分析如下。例1,男,56岁,因突然头痛,恶心呕吐,左侧肢体活动受限4天,于1990年7月19日入院。5年前患脑血栓。CT示:50～80mm层面见大片状密度不均影。脑室受压,中线左移。查体:BP26/13kPa。内科查体无明显阳性体征。神经系统:神志清楚,情绪激动,双眼视乳头色红,边界模糊,A:V=2:4,余颅神经未见异常。左上肢肌力0级,左下肢肌力Ⅲ级,深浅感觉正常,颈无抵抗。诊断颅内肿瘤。入院后5天行右侧额颞部去骨瓣减压术,并送检病理。回报:脑组织部分软化。术后诊断;脑梗塞。并给予降颅压,神经细胞活化剂治疗,病情一度好转。1个月后,头痛、恶心呕吐加重。查:右侧眼裂变小,左侧软腭抬举无力,悬雍垂歪向左侧,左侧肢体肌力Ⅱ级,张力正常,左侧深感觉存在,痛觉减退。CT增强扫描45～65mm层,右侧脑室三角区后方枕叶可见2.8×2.1cm增强影,
Tumor incidence of brain metastases more common, but postoperative misdiagnosis of cerebral infarction rare, I encountered two cases, are analyzed as follows. Example 1, male, 56 years old, admitted to hospital on July 19, 1990 due to a sudden headache, nausea and vomiting, and limited physical activity on the left limb for 4 days. 5 years ago with cerebral thrombosis. CT shows: 50 ~ 80mm level see the large density of uneven film. Ventricular compression, midline left. Physical examination: BP26 / 13kPa. Physical examination no obvious positive signs. Nervous system: conscious, emotional, binocular papillary red, fuzzy boundaries, A: V = 2: 4, I cranial nerve showed no abnormalities. Left upper limb muscle strength 0, left lower extremity muscle strength Ⅲ, shades feel normal, neck without resistance. Diagnosis of intracranial tumors. Five days after admission, the frontal frontotemporal debridement was performed and pathology was performed. Reward: Brain tissue partially softened. Postoperative diagnosis; cerebral infarction. And given intracranial pressure, nerve cell activator treatment, the condition was improved. After 1 month, headache, nausea and vomiting worsened. Check: the right eye fissure is small, left soft palate lift weakness, uvula crooked to the left, left limb muscle strength Ⅱ level, normal tension, the left deep feeling exists, pain decreased. CT enhancement scan 45 ~ 65mm layer, the right lateral ventricle triangle occipital lobe 2.8 × 2.1cm enhanced shadow,