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51.
小脑后下动脉动脉瘤的诊断和治疗 总被引:1,自引:0,他引:1
目的探讨小脑后下动脉动脉瘤的临床特征、诊断、鉴别诊断和治疗。方法回顾性分析12例小脑后下动脉瘤的临床表现、影像学特征、手术效果及诊治过程中存在的相关问题。结果12例中有11例因动脉瘤破裂出血而发病,单纯第四脑室出血4例,全脑室系统出血2例,小脑半球出血3例,小脑蚓部伴第四脑室出血1例,侧脑室伴第三脑室出血1例,以后颅窝占位病变表现1例。8例术前行DSA检查明确诊断,4例术中明确诊断。12例均行后颅窝开颅显微手术治疗,其中动脉瘤颈夹闭9例,孤立切除2例,动脉瘤加固术1例,术后2例因脑积水加重行脑室-腹腔分流术。12例中除1例术后留有轻偏瘫外,其余11例恢复良好。结论小脑后下动脉瘤多以第四脑室出血发病,少数以小脑半球或蚓部出血发病,及早治疗效果满意。手术方式应尽量夹闭动脉瘤颈,对于小脑后下动脉末端动脉瘤,可以采用孤立切除术。 相似文献
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53.
目的探讨社区干预治疗对促进脑梗死患者功能恢复的效果。方法以自愿的方式选择通州区经委社区卫生服务站和八里桥社区卫生服务站所管辖社区内38例脑梗死恢复期患者随机分为治疗组和对照组,对治疗组患者进行为期1年的社区干预治疗,比较治疗组与对照组患者功能恢复情况(日常生活活动能力)。结果通过1年的早期社区干预治疗,治疗组较对照组患者功能恢复效果明显提高(P<0.01)。结论早期社区干预治疗对脑梗死患者功能恢复有促进作用。 相似文献
54.
采用SD大鼠一侧大脑中动脉阻断致局限性脑缺血模型。脑缺血后迅速断头置于液氮中,HPLC外标定量法测定各磷脂组分。观察脑缺血1、5、15、60、360min时脑细胞膜磷脂含量变化。结果显示,PI在缺血早期显著低于对照组(P<0.01~0.05);PE、PC早期仅呈下降趋势,PE在缺血60min组、PC缺血360min组显著低于对照组(P<0.01~0.05)。PS在缺血全过程中变化轻微(P>0.05)。提示磷脂降解与脑缺血存在一定关系,缺血早期首先出现脑细胞膜功能磷脂降解,膜结构磷脂则在缺血后期出现显著变化,且PE较PC优先降解。 相似文献
55.
S.L. Atkin A.M. Coady D. Horton N. Sutaria L. Sellars C. Walton 《Diabetic medicine》1995,12(3):267-270
A 15-year-old girl presented de novo in diabetic ketoacidosis having been comatose for 24 h (day 1). A CT scan and lumbar puncture performed on admission were normal and her conscious level slowly improved over several days. On day 7 she had central neurological signs of bilateral knee clonus and an extensor plantar response. In addition, she had developed lower motor neurological signs of an ulnar nerve palsy of the left forearm, and ulnar, median, and radial nerve palsies of the right forearm. Magnetic resonance imaging (MRI), performed on day 12, showed multiple small cerebral haematomata with appearances at least several days of age. The scattered lesions were localized particularly to the parieto-occipital region, with sparing of the basal ganglia and without cerebral oedema, a novel feature not previously described in juvenile ketoacidosis. Four months later there was minimal residual disability of her right arm. The clinical findings together with the MRI images suggested that the peripheral nerve and central lesions were temporally related, suggesting a common aetiology. However, it is likely that MRI showed cerebral lesions which may have been missed by the conventional CT scanning performed initially. 相似文献
56.
The hypothesis that benzodiazepine-induced hyperphagia is due to a specific enhancement of the palatability of foods has been supported by previous ‘taste reactivity’ studies of affective (hedonic and aversive) reactions to taste palatability. Diazepam and chlordiazepoxide enhance hedonic reactions of rats (rhythmic tongue protrusions, etc.) to sweet tastes in a receptor-specific fashion. A role for brainstem circuits has been indicated by a previous demonstration of the persistence of the taste reactivity enhancement by diazepam after midbrain decerebration. The present study examined whether benzodiazepine brainstem receptors are the chief substrates for palatability enhancement even in intact brains. We compared the effectiveness of benzodiazepine microinjections to elicit feeding and enhance hedonic reactions when delivered into either the lateral ventricle (forebrain) or the fourth ventricle (brainstem) of rats. The results show diazepam is reliably more effective at eliciting feeding and enhancing positive hedonic reactions to oral sucrose when microinjections are made in the fourth ventricle than in the lateral ventricle. We conclude that brainstem neural systems containing benzodiazepine-GABA receptors are likely to be the chief substrates for benzodiazepine-induced palatability enhancement. 相似文献
57.
58.
风心病并发脑栓塞病人的瓣膜替换术 总被引:11,自引:0,他引:11
报告64例风心病并发脑栓塞病人的瓣膜替换术。术前心功能I级10例、II级38例、IV级16例。伴房颤者54例。脑栓塞史半年以上者44例,6个月以内20例,其中2个月以内者14例。34例有程度不同的脑栓塞后遗症。行二尖瓣替换术47例、双瓣膜替换术17例,同期行三尖瓣环环缩或成形术43例。术中证实有左房血栓25例(39%)。手术死亡率6.25%。术后并发颅内出血和栓塞各1例。结果表明风心病并发脑栓塞病人的手术效果良好。作者指出,脑栓塞2个月以上者应尽早手术,2个月以内者则应根据脑栓塞程度、恢复情况及有无左房血栓,选择手术时机。并介绍了围术期的处理经验。 相似文献
59.
We studied the effects of Wallerian degeneration in the cerebral peduncle shown by magnetic resonance imaging (MRI) following a supratentorial vascular lesion, to identify the somatotopic localisation of the descending cortical tracts. Patients with a lesion involving a large area of a cerebral hemisphere had an area of abnormal signal intensity in the whole cerebral peduncle, suggesting Wallerian degeneration of all the whole descending cortical tracts. With a small lesion confined to the precentral gyrus, corona radiata, or posterior limb of the internal capsule there was an abnormal signal at the centre of the peduncle, suggesting degeneration of the precentrospinal tract. Those with a small lesion confined to the paracentral gyrus had an abnormal area slightly lateral to the centre of the peduncle, suggesting degeneration of the parietospinal tract. Patients with a lesion of the parietal or temporal lobes, not including the paracentral or precentral gyri, corona radiata, or the posterior limb of the internal capsule, had an abnormal area laterally in the peduncle, suggesting degeneration of the parietopontine or temporopontine tract. 相似文献
60.
彩色多普勒和磁共振对健康人颅内动脉影像学的比较研究 总被引:1,自引:0,他引:1
目的通过彩色多普勒和磁共振血管成像对健康人颅内动脉的检测,初步确定其操作规范及衡量标准。方法正常人200例,按照检查方法分为彩色多普勒血流显像(ColourDopplerFlowImaging,CDFI)组及磁共振血管成像(MagneticReso-nanceAngiography,MRA)组。CDFI组观察大脑中动脉(MiddleCerebralArtery,MCA)、椎动脉(VertebralArtery,VA)各段的血流动力学改变和相应点的血流束内径。MRA组检测相应血管对应部位的血管内径。结果同一条血管不同位置的血流速率有差异(P<0.05);同名血管相应位置的血流速率左侧略高于右侧,女组高于男组,但无统计学意义(P>0.05)。按年龄分组,相邻组间无显著性差异,相隔组间有显著性差异。CDFI所测血流束内径较MRA所测血管内径值偏高,且P<0.05,差异有显著性。结论a)应用CDFI能显示MCA,VA走行,可检测血管的血流动力学的改变。b)要提高临床脑血管疾病诊断的准确性,必须有规范的临床操作和可靠的检测指标。c)对血管内径的测量MRA更佳。 相似文献