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1.
我院l993~1999年急诊中共收治由于服胃药而引起的急性肌张力增高的锥体外系反应病人32例,现报告如下。1 资料1.1 一般资料:男18例.女14例,年龄4个月~45岁,其中4~6个月3例;7个月~1岁12例;2~3岁6例;4~8岁4例;14~18岁3例,19~45岁4例。其中服胃复安29例(剂量:7个月~l岁患儿2~2.5mg/次;2~3岁 3.3 mg/次;4~8岁 5mg/次;14~45岁10 mg/次,均每日3次,其中2例成人用药达2周),吗叮啉3例(4~6个月患儿)。急性起病(服药l~2天…  相似文献   

2.
外伤性脑梗死6例分析   总被引:3,自引:0,他引:3  
外伤性脑梗塞是指脑外伤后经CT复查后发现梗死灶。临床报道较少,现将我院自1993年3月至1999年7月共收治的6例报告如下。1临床资料1.1一般资料 本组6例,男4例、女2例,年龄最小2岁,最大56岁,平均27.5岁,其中儿童患者2例。1.2临床表现 4例患者伤后出现短暂神志改变,清醒后伴不同程度的头晕、头痛、呕吐。其中单瘫2例,轻偏瘫2例,视野改变1例,抽搐发作2例,锥体束征阳性5例。1.3 CT扫描所见 CT扫描时间均在伤后24h内,并于一周内复查。全部病例为局灶性脑梗死,未发现大面积脑梗死。6…  相似文献   

3.
红细胞变形性在脑梗塞病中的改变乔玉荷,高东美,李建森我们观察了53例脑梗塞患者的红细胞变形性及治疗前后的对照,报道如下。1临床资料1.1脑梗塞组脑梗塞病人53例,全部经头颅CT明确诊断,其中男49例,女4例。年龄47~83岁,平均63.5岁,合并高血...  相似文献   

4.
氯硝安定对抑郁状态的疗效观察祝英禄作者以氯硝安定治疗5例抑郁症患者,均有良好疗效。患者均系女性,年龄27~45岁。病期3年2例,2周3例。均有情绪低沉,消极观念或行为等症状,按CCMD—2—R诊断,1例为分裂情感性精神病抑郁型,4例为抑郁症,其中1例...  相似文献   

5.
脑出血急性期并发癫痫15例报告   总被引:3,自引:0,他引:3  
我院于1995~1998年收治脑出血患者214例,其中并发癫痫者15例(7%),现将有关资料分析如下。1 临床资料本组15例,男9例,女6例。年龄36~71岁(平均58.5岁),45~50岁2例,51~60岁11例。脑出血后距发作癫痫时间:12小时内4例,12~24小时5例,1~2天3例,3~5天2例,6天1例。癫痫发作类型:局限性运动发作6例,大发作9例(其中癫痫连续发作2例)。患者住院6小时~45天(平均13.5天),每个患者在院发作1~3次(平均1.33次),3小时~20天(平均10.1天…  相似文献   

6.
一、临床资料与方法男5例,女5例。年龄34~67岁。均以蛛网膜下腔出血发病。动脉瘤位于后交通动脉4例,前交通动脉1例,大脑中动脉(M1段)1例,颈内动脉分叉部1例,颈内动脉C2段、C3段、C4段(海绵窦段)各1例。10例均应用进口微钨丝弹簧圈,其中2...  相似文献   

7.
本文总结我院四年来并发于脑卒中的糖尿病非酮症高渗性昏迷12例,现分析报道如下:1临床资料1.1一般资料 12例患者,男7例,女5例,年龄 45-71岁,平均64岁。原发病为高血压性脑出血5例,脑梗死4例,蛛网膜下腔出血2例,脑室出血1例,全部经头颅CT检查证实。10例有糖尿病史(分别2-15年)。均为Ⅱ型糖尿病,另2例为首次发现糖尿病。1.2诊断依据12例患者原发病引起的意识障碍较轻,其中2例昏睡患者(1例为脑室出血,1例为基底节区脑出血)经脑室穿刺引流及血肿穿刺抽吸,意识已转清,但随着血糖及血浆…  相似文献   

8.
出汗异常是自主神经功能障碍中最常见的症状之一。本文报道5例脑梗塞伴对侧躯体出汗异常患者。3例为大脑中动脉区梗塞、2例为脑岛皮层区梗塞。出汗部位以额和前臂明显,持续1~4天,未发现其它自主神经功能障碍。本文就5例患者并结合有关文献对其预防、临床特征、发病机理及临床意义作一讨论。  相似文献   

9.
脑梗塞患者颈动脉粥样硬化斑块的超声检测及其临床意义   总被引:7,自引:0,他引:7  
目的:探讨颈动脉粥样硬化斑块好发部位、狭窄程度及与脑梗塞的关系。方法:对100例脑梗塞患者及正常对照组90例进行颈动脉超声检测,了解有无斑块形成及狭窄程度,结果:100例脑梗塞患者中发现颈动脉内存在不同程度的颈动脉粥样硬化斑块有72例且好发于颈动脉分叉部。正常对照组90例发现颈动脉粥样硬化25例,梗塞组与对照组比较,有显著差异(P<0.01)。结论:颈动脉粥样硬化斑块是引起脑梗塞的重要原因。  相似文献   

10.
1对象与方法1.1一般资料男8例,女13例;年龄15~70岁,平均45.7岁;病程3个月~5年,平均3.2年。临床表现:头痛15例,呕吐9例,视力障碍9例,癫4例,嗅觉消失4例。21例术前均行CT及MRI检查(其中5例行MRA检查),5例行DSA检查。1.2肿瘤部位前颅窝底8例:嗅沟5例,鞍结节和鞍上3例;中颅窝底9例:蝶骨嵴内1/34例,中外1/33例;颅眶沟通2例;后颅窝4例:桥小脑角3例,天幕1例。肿瘤直径<3cm5例,3~5cm10例,>5cm6例。1.3手术入路视肿瘤位置选择不同手术入路:前颅底肿瘤…  相似文献   

11.
OBJECTIVES--In major cerebral arterial occlusive diseases, patients with inadequate blood supply relative to metabolic demand (misery perfusion) may be at increased risk for cerebral ischaemia. This study investigated whether patients showing misery perfusion on PET have a high risk of recurrent ischaemic stroke. METHODS--The relation between the regional haemodynamic status of cerebral circulation and the subsequent risk of recurrent stroke was prospectively evaluated in 40 patients with symptomatic internal carotid or middle cerebral arterial occlusive diseases who underwent PET. Patients were divided into two haemodynamic categories according to the mean hemispheric value of oxygen extraction fraction in the hemisphere supplied by the artery with symptomatic disease: patients with normal oxygen extraction fraction and those with increased oxygen extraction fraction (misery perfusion). All patients were followed up for at least 12 months. RESULTS--The one year incidence of ipsilateral ischaemic strokes for patients with normal oxygen extraction fraction and those with increased oxygen extraction fraction were two of 33 and four of seven patients respectively. A significantly higher incidence of ipsilateral strokes was found in patients with increased oxygen extraction fraction (Fisher's exact test; P = 0.005). In patients with increased oxygen extraction fraction, three of four strokes were watershed infarctions and the location of the infarction corresponded with the area of increased oxygen extraction fraction. CONCLUSION--These findings contradict conclusions of a previous study and suggest that patients with major cerebral arterial occlusive diseases and misery perfusion have a high risk for recurrent ischaemic stroke.  相似文献   

12.
Capsular infarcts: the underlying vascular lesions.   总被引:4,自引:0,他引:4  
In ten patients, 11 infarcts involving mainly the internal capsule have been examined pathologically. Serial sections of the involved basal ganglia were studied in ten infarcts and only a gross dissection was made in the other. The implicated penetrating arteries were traced throughout their length and obstructive vascular lesions were found in nine instances. In two of the nine there was an atheromatous plaque with a superimposed thrombus, in four an atheromatous plaque had caused severe stenosis, in one a destructive arterial process lipohyalinosis had occurred, in one case the nature of the obstruction remained "uncertained," and in one the penetrating arteries were obstructed at their orifices by an atheroma in the superior division of the middle cerebral artery. In two cases the vessels were patent, suggesting embolism. The atheromas consisted almost exclusively of a conglomerate of fat-filled macrophages. The clinical correlate was a pure motor hemiplegia or hemiparesis involving the face, arm, and leg without sensory deficit, homonymous hemianopia, receptive aphasia, or apractognosia. Confusion was prominent in one patient.  相似文献   

13.
K Nakajima 《Brain and nerve》1990,42(9):821-834
From the years 1977 through 1989, the author experienced 27 cases with only anterior cerebral artery (ACA) occlusion but without any other main cerebral arterial occlusions. These were proven by cerebral angiographies and verified by CT. Two patients showing large infarction in the left frontal lobe on CT but showing no evidence of arterial occlusion by cerebral angiography were also registered in this study because these patients were thought to have recanalized ACA. There were 15 males and 12 females with an age of 61.5 +/- 7.98 (mean +/- SD) and 66.1 +/- 6.45, respectively. Twenty two cases had cerebral thrombosis and 5 had cerebral embolism. There were 4 cases with bilateral ACA occlusions, 8 with right ACA occlusion and 15 with left ACA occlusion. Twenty two patients (81%) were alert on admission and this fact might explain their excellent ADL on discharge: full recovery in 9 patients (33%) and self-management in 12 patients (44%). Seventeen patients (63%) had a CT-proven infarcted area with a correlation to ACA occlusion (s), while 9 patients (33%) showed no correlation between an infarction on CT and an ACA occlusion. One patient showed no abnormal findings on CT. Four patients with right ACA occlusion were incidentally observed, even though their mode of onset was strokes. The symptoms of the other 23 patients were those of anterior cerebral artery syndromes: hemiparesis (74%), urinary incontinence (39%), forced grasping (39%), mutism (30%), indifference (26%) and apraxia (22%) etc.  相似文献   

14.
An analysis of 617 cases of cerebral strokes was done, including 534 acute and 83 past ones treated in the years 1966-1972. The patients were divided into 4 groups: I -- cerebral haemorrhage, II -- cerebral embolism, III -- cerebral arterial thrombosis, IV -- failure of cerebral circulation. The classification was based on clinical criteria and in dying patients also on autopsy findings. ECG changes were analysed in all patients. In the acute period of stroke the greatest proportion of cases were cerebral arterial thrombosis (197 cases --37%) and in this group acute myocardial infarctions were most frequent. This group was followed by cases of acute cerebral circulatory failure (191 cases -- 35%). The electrocardiographic correlate of the cerebral changes were in this group signs of myocardial ischaemia (84 cases -- 15%). Cerebral embolism (134 cases -- 24%) was associated with arrhythmia (109 cases --19) of various origin. In the group of cerebral haemorrhages (95 cases -- 17%) no unequivocal ECG changes were observed. In all patients with myocardial infarction during cerebral stroke atheromatous changes of coronary arteries were present. No correlation was observed between the location of the cerebral focus and the type of electrocardiographic changes.  相似文献   

15.
目的分析TIA及TIA形式的脑梗死的临床特点,探索其临床相关因素。方法回顾性分析83例初步诊断为TIA并在症状首发后24 h内行常规MRI及DWI检查的患者,发病1周内行颈部动脉血管彩超、TCD。记录发病后7 d内的临床转归。根据DWI结果分为DWI+组及DWI-组,确定DWI阳性率。比较DWI+组及DWI-组临床特征差别。分析两组患者动脉粥样硬化斑块的部位、性质、数量及颅内外血管狭窄的部位、程度。结果DWI阳性率为36.1%。DWI阳性与动脉粥样硬化相关(P=0.03),与颈部动脉动脉粥样硬化斑块数目相关(P=0.04),TIA症状首发后7 d内,30.0%DWI+组患者TIA症状反复发作或表现为临床症状持续存在,高于DWI-组(22.6%)。结论临床表现为TIA的病例大于1/3急性期已经形成了脑梗死,动脉粥样硬化斑块数量越多,DWI阳性的可能性越大,DWI+的患者7 d内更易进展。  相似文献   

16.
Cerebral infarction and migraine: clinical and radiologic correlations   总被引:1,自引:0,他引:1  
Cerebral infarction was documented by arteriography and serial computed cranial tomography (CT) in four young adults (ages 16 to 32 years) with migraine. In one case, posterior cerebral artery occlusion produced a deep parietotemporal infarct. The other three cases all had frontotemporal infarcts (one hemorrhagic) in the territory of the middle cerebral artery, without major arterial occlusion. Two infarcts produced lasting neurologic deficits; one was associated with mild, transitory symptoms, and one was asymtomatic. Laboratory investigations in two cases revealed no hematologic or cardiovascular predisposition to cerebrovascular disease. Cerebral infarction, as revealed by CT, may be more prevalent in "complicated" migraine than is generally appreciated. Such lesions may or may not develop in chronologic and anatomic relationship to the headache, and may involve either large or small arteries. The prognosis for functional recovery, based on this limited sample, seems favorable.  相似文献   

17.
The pattern of arterial occlusion and related lesions have been studied in 26 cases with 38 medullary infarcts. In 10 of these cases, only the intracranial vessels were examined. In the 16 other cases, the entire cerebral arterial supply was dissected.Medial infarcts were more often related to occlusion of the vertebral artery involving the termination of the artery (710cases). In 6 cases a thrombosis on an atheromatous plaque and, once, an embolus of cardiac origin, were found.Lateral infarcts were usually due either to occlusion of the vertebral artery (1423cases), reaching, in 10 cases, the mouth of the posterior inferior cerebellar artery (PICA) or to an isolated occlusion of the latter vessel (3 cases). A thrombosis on an atheromatous plaque was found in 15 cases, and emboli from the heart or from the origin of the vertebral artery in the others.The dorsal infarcts were related, in 45cases, to an isolated occlusion of the stem of the PICA and, in the other case, to one of the vertebral artery involving the ostium of the PICA. A thrombosis due to atheromatous stenosis was found in 4 cases, an embolus of cardiac origin in the other one.  相似文献   

18.
大脑中动脉狭窄脑深部小梗死发病机制的研究   总被引:1,自引:0,他引:1  
目的 研究大脑中动脉粥样硬化性狭窄患者脑深部小梗死的发生频率和发病机制。方法86例发病时间〈1周的急件脑梗死患者,行经颅多普勒超声、彩色超声、磁共振血管造影及功能磁共振成像等检查方法被明确诊断为症状性大脑中动脉粥样硬化性狭窄,并排除颈内动脉病变、心源性栓塞以及非动脉粥样硬化性狭窄。利用磁共振扩散加权成像观察梗死灶的形态学表现及特点,分析其发病机制。结果37例(43.02%)症状性大脑中动脉粥样硬化性狭窄患者存在深部小梗死,多呈孤立性单发病灶。其中内囊纹状体梗死及巨大腔隙者18例(20.93%),梗死灶体积多超过两个层面,少数病灶呈多灶分布的特点;直径较小的腔隙性梗死19例(22.09%),梗死灶体积〈15mm,多位于一个层面内。伴有大脑中动脉粥样硬化性狭窄的深部小梗死的患者,病情多不稳定,预后较差。所有脑深部小梗死患者均伴有大脑中动脉主干支狭窄,且梗死灶体积与大脑中动脉粥样硬化性狭窄程度有关,内囊纹状体梗死多见于大脑中动脉重度狭窄者。结论约50%大脑中动脉粥样硬化性狭窄患者存在脑深部小梗死,其发病机制与大脑中动脉粥样硬化斑块或斑块残端血栓蔓延堵塞深穿支动脉入口有关。对此类患者的治疗不同于经典的腔隙性脑梗死。  相似文献   

19.
D Samson  C Watts  K Clark 《Neurology》1977,27(8):767-771
Thirty-one patients with cerebral transient ischemic, attacks and ipsilateral internal carotid artery occlusion without contralateral internal carotid artery occlusion or stenosis were treated with a surgical anastomosis between a superficial temporal artery and a cortical branch of the middle cerebral artery of the symptomatic hemisphere. The anastomosis was successful in 28 patients. Recurrent transient ischemic attacks were abolished in 23 patients and reduced in three. Two patients, one with a patent anastomosis, had strokes during the follow-up period. Of seven patients who refused the operation, two had strokes, two noted a reduction of transient ischemic attacks, two noted no change, and one became asymptomatic.  相似文献   

20.
It is reasonable to speculate that migrainous infarction may develop in different territories of cerebral arteries. However, this condition was rarely reported before. Here we described two patients (one woman, 29 year-old; one man, 47 year-old) with a history of migraine with aura, had ischemic strokes during the migraine attack. The ischemic stroke of the female patient involved the territories of the posterior cerebral and anterior choroidal arteries; whereas the male patient had two episodes of ischemic strokes, involving the territories of the middle and posterior cerebral arteries sequentially. Both patients recovered well during the follow-up periods. We suggest that migrainous infarction can involve different arterial territories.  相似文献   

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