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本文报告一例双壳核部对称性脑梗塞并发尿失禁患者,经脱水等治疗,预后良好,现就其发生原因及临床意义,探讨如下:病例介绍:男性,53岁。拟尿失禁,左下肢无力于1987年11月19日入院。18日无明显诱因,自觉左下肢无力,尿裤子,测血压180/120mmHg,症状逐渐加重。病后无头痛、恶心、呕吐。既往高血压史多年,自服降压药,无明显好转。查体:T36.4℃,P80次/分,R20次/分,BP170/120mmHg.意识清楚,查体合作,答问准确。双瞳孔同圆等大,对光反应灵敏,眼球运动充分,眼震(-).右鼻唇沟略浅,伸舌居中,两耳听力正常.心肺听诊正常.四肢肌力、肌张力正常,生理反射存在,未引出病理反射。血像、血液生化学检查正常,血糖80mg%,全血、血浆比粘度各为6.39,1.78。红细胞压积52%。眼底:双乳头境界清,视网膜动脉变细,反光增强,可见动静脉压迹。头部CT 检查:示双壳核部及左侧脑室体旁斑片状低密度灶。诊断为急性缺血性脑血管病,双壳核部梗塞。给予20%甘露醇25ml,
This article reports a case of bilateral bimodal symmetry cerebral infarction in patients with urinary incontinence, after dehydration and other treatment, the prognosis is good, now its causes and clinical implications, discussed as follows: Case description: Male, 53 years old. Mimi incontinence, left lower extremity weakness in November 19, 1987 admission. No obvious incentive on the 18th, conscious left lower extremity weakness, urine pants, blood pressure 180 / 120mmHg, the symptoms gradually worsened. After the illness without headache, nausea, vomiting. Past history of hypertension for many years, self-service antihypertensive drugs, no significant improvement. Physical examination: T36.4 ℃, P80 beats / min, R20 beats / min, BP170 / 120mmHg. Awareness, physical examination, accurate answer. Double pupil with the circle and so on, sensitive to light, full eye movements, nystagmus (-) .Right nasolabial groove slightly shallow, middle tongue, both ears hearing normal .A cardiopulmonary auscultation .Lymbit muscle strength, muscle tone normal, Physiological reflex exists, did not lead to pathological reflex. Blood, normal blood biochemistry, blood glucose 80mg%, whole blood, plasma specific viscosity of 6.39,1.78. Hematocrit 52%. Fundus: double nipple realm of clear, narrowing of the retina arteries, reflex enhanced visible arteriovenous track. Head CT examination: showed bivalve nuclei and left ventricular mass patchy low density lesions. Diagnosis of acute ischemic cerebrovascular disease, bivalve nuclear infarction. Given 20% mannitol 25ml,