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目的 分析不典型脑干梗死的临床症状与体征 ,探讨其诊断特点与误诊原因。方法 经MRI证实的脑干梗死 6 5例 ,选择其中检查前未确诊或诊断有误的 2 3例 ,就其病因、临床表现、诊断特点与误诊因素进行分析。结果 绝大多数有中风危险因素 ,病情变化快 ,部分病例有前驱症状 ,体征多样化 ,均无典型交叉瘫等脑干症状和体征。结论 部分脑干梗死病人可无典型症状体征 ,表现多样化。在没有特殊确诊手段的情况下 ,诊断时要考虑到脑干病变的可能性。
Objective To analyze the clinical symptoms and signs of atypical brainstem infarction and discuss its diagnostic features and causes of misdiagnosis. Methods Sixty-five cases of cerebral infarction confirmed by MRI were selected. Among them, 23 cases were diagnosed as undiagnosed or incorrectly diagnosed, and their etiological factors, clinical manifestations, diagnostic features and misdiagnosis factors were analyzed. Results Most of the risk factors for stroke, the rapid changes in the disease, some cases have prodromal symptoms, signs and diverse, no typical symptoms of cerebral palsy and other symptoms of cross paralysis. Conclusion Some patients with brain stem infarction may have typical symptoms and signs, showing diversity. In the absence of special means of diagnosis, diagnosis should take into account the possibility of brain stem lesions.