论文部分内容阅读
我院1984～1990年收治老年人脑肿瘤26例,初诊均误诊,后经颅脑CT纠正诊断。 一、临床资料 男19例,女7例,年龄60～70岁,平均年龄62.2岁。卒中样起病者23例,病程 1周至 1年半。 主要临床表现和体征为头痛、恶心呕吐、癫病发作、肢体麻木、高血压、智能和精神障碍、中枢性面瘫、中枢性肢体瘫、偏身感觉障碍。病理征18例。脑脊液压力>20.39kPa12例,蛋白含量均增高(0.52～1.26/L),3例白细胞增高,14例ESR增快,8例血脂高。 26例病人在门诊及入院初诊时诊断为脑血栓形成23例, TIA 3例。后经颅脑CT检查,均见脑内不同部位的占位性病变,多表现高密度影或混杂影像,周围有水肿带,11例脑室受压变形,中线结构明显移位。根据CT结合临床,诊断为胶质瘤15例,卵巢癌脑转移2例,肺癌脑转移1例,原发处不明4例,听神经瘤1例,性质未定3例。 二、误诊原因分析 老年人脑肿瘤起病缓,病程长,颅内压增高及
Our hospital from 1984 to 1990 admitted 26 cases of brain tumors in the elderly, first diagnosis was misdiagnosed, after the diagnosis of brain CT. First, the clinical data of 19 males and 7 females, aged 60 to 70 years, mean age 62.2 years old. Stroke-like illness in 23 cases, duration of 1 week to 1 year and a half. The main clinical manifestations and signs of headache, nausea and vomiting, epilepsy attacks, limb numbness, hypertension, mental and mental disorders, central facial paralysis, central limb paralysis, partial sensory dysfunction. Pathological sign in 18 cases. Cerebrospinal fluid pressure> 20.39kPa in 12 cases, protein content increased (0.52 ~ 1.26 / L), 3 cases of leukocytosis, 14 cases of ESR increased, 8 cases of high blood lipids. Twenty-six patients were diagnosed as cerebral thromboembolism in outpatients and admissions at first visit in 23 cases and TIA in 3 cases. After the brain CT examination, were seen in different parts of the brain space-occupying lesions, the performance of high density or mixed images, surrounded by edema zone, 11 cases of ventricular compression deformation, significant shift in the midline structure. According to CT combined with clinical diagnosis of glioma in 15 cases, 2 cases of ovarian cancer brain metastases, brain metastases in 1 case of lung cancer, 4 cases of unknown origin, acoustic neuroma in 1 case, the nature of undetermined in 3 cases. Second, the reasons for misdiagnosis The elderly brain tumors onset slow course, increased intracranial pressure and