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在急性脑血管病中,以脑出血较常见,但尾状核出血很少被人注意,以往临床也很难作出诊断。最近我们收治二例尾状核出血,临床均误诊为蛛网膜下腔出血,后经CT脑扫描始证实。鉴于国内尚无报道,现报告于下: 例1:李××,女,52岁,工人。因意识不清、头痛、呕吐三天,于1984年12月28日入院。检查:BP170/120mmHg,意识不清,颈有抵抗,四肢无活动障碍,腱反射低下,但对称,双侧可引出Chaddock氏征。眼底检查:高血压视网膜病变,双侧视乳头水肿.腰穿检查:脑脊液呈血性,初压大于300mmH_2O,入院诊断:蛛网膜下腔出血。后经CT脑扫描证实为右基底节尾状核头部血肿17.9×24.3mm~2,突向右侧脑室前角(图1)。入院后经降血压、脱水降颅压,止血等治疗,一月后临床症状基本痊愈,复查脑脊液也
In acute cerebrovascular disease, cerebral hemorrhage is more common, but caudate nucleus hemorrhage is rarely noticed, in the past it is difficult to make clinical diagnosis. Recently we treated two cases of caudate nucleus bleeding, clinically misdiagnosed as subarachnoid hemorrhage, after CT brain scan confirmed. In view of the fact that there is no report in our country, the report is as follows: Example 1: Li × ×, female, 52 years old, worker. Due to confusion, headache, vomiting for three days, on December 28, 1984 admission. Check: BP170 / 120mmHg, confusion, neck resistance, limb movement disorders, low tendon reflexes, but the symmetry can lead to Chaddock’s syndrome on both sides. Fundus examination: Hypertensive retinopathy, bilateral papilledema.Lumbar puncture examination: cerebrospinal fluid was bloody, initial pressure greater than 300mmH2O, admission diagnosis: subarachnoid hemorrhage. After the CT scan confirmed by the right basal ganglia caudate nucleus hematoma 17.9 × 24.3mm ~ 2, protruding to the right ventricular anterior horn (Figure 1). After admission by lowering blood pressure, dehydration reduced intracranial pressure, hemostasis and other treatment, clinical symptoms basically recovered after January, review cerebrospinal fluid