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目的探讨脑干梗死罕见临床表现,减少误诊误治。方法收集2005-04以来诊治5例脑干梗死患者的临床资料,总结其罕见临床表现,进行分析。结果 2例早期溶栓治疗后意识完全恢复正常,其中1例肢体功能同时完全恢复正常,1例遗留左侧肢体轻瘫;3例治疗后散大的瞳孔恢复至正常范围,意识未恢复。结论昏迷患者双侧瞳孔明显不等大,且呈中等程度散大时,头颅CT检查未见责任病灶,应诊断为脑干梗死,积极溶栓治疗。
Objective To explore the rare clinical manifestations of brainstem infarction and reduce misdiagnosis and mistreatment. Methods The clinical data of 5 patients with brain stem infarction who were diagnosed and treated since 2005-04 were collected and their rare clinical manifestations were summarized and analyzed. Results Two cases of early thrombolytic therapy regained consciousness completely. One of the two limbs completely recovered to normal function at the same time. One case had left limb paralysis. Three pupils recovered to the normal range after the treatment, and the consciousness did not recover. Conclusions The bilateral pupils in patients with unconsciousness were significantly different from each other. When the patients were moderately scattered, cranial CT examination showed no responsibility lesions and should be diagnosed as brainstem infarction and active thrombolytic therapy.