不典型脑出血早期诊断较困难,易与脑血栓混淆而误诊。本文报告4例,并结合文献探讨其诊断。例1、男,58岁。入院两天前午睡后右侧肢体麻木,活动受限。既往无高血压病史。检查:神志清,言语含糊,无头痛及呕吐等。血压180/100mmHg。瞳孔等大,眼底无水肿及出血,右中枢性面瘫,伸舌偏右,右上下肢肌力0°,右巴彬斯基氏征(+),颈软,克氏征(-)。病后三天腰穿脑脊液清亮,脑压100mmH_2O,检验内容正常。按脑血栓治疗,静滴低分子右旋糖酐(1次/日),三 Atypical early diagnosis of intracerebral hemorrhage more difficult, easily confused with cerebral thrombosis and misdiagnosis. This article reports 4 cases, combined with the literature to explore its diagnosis. Example 1, male, 58 years old. Two days before admission, the right limb numbness after nap, limited activities. No previous history of hypertension. Check: delirious, verbal vague, no headache and vomiting. Blood pressure 180 / 100mmHg. Pupil and other large, fundus without edema and bleeding, right central facial paralysis, stretch tongue right, right upper extremity muscle strength 0 °, right Babinski’s sign (+), neck soft, Kirschner sign (-). Three days after the disease, lumbar puncture cerebrospinal fluid clear, brain pressure 100mmH_2O, test content is normal. Treatment by cerebral thrombosis, intravenous infusion of low-molecular dextran (1 / day), three