双侧大脑半球相继出血及血肿扩大合并脑干梗死的混合性卒中2例分析

目的探讨双侧大脑半球相继出血及血肿扩大合并脑干梗死的混合性卒中的可能发病机制、病因及诊治对策。方法对2例双侧大脑半球相继出血及血肿扩大合并脑干梗死的混合性卒中患者起病形式、临床表现、影像学特征以及疾病演变经过、诊治过程进行分析。结果 2例患者的起病形式、临床表现,以及影像学特征、疾病演变过程都极为相似而其脑血管病的危险因素有所不同。结论大脑半球相继出血及血肿扩大合并脑干梗死的病因、发病机制复杂,患者可能都存在相同对称的脑血管结构异常物质基础以及促发因素、脑血流动力学因素、血管活性物质的变化因素等,而脑血管病的危险因素有所不同,在诊断对策上要积极寻找原因,治疗上要慎重而周全,以免误诊误治。

Analysis of 2 cases of mixed stroke that bilateral cerebral hemorrhage at different time with hematoma enlargement and brain stem infarction

Objective To investigate the possible mechanism,etiology and treatment of mixed stroke of bilateral successive cerebral hemorrhage with hematoma enlargement and brain stem infarction.Methods The onset mode,clinical manifestation,imaging character,development and treatment of 2 collected cases were analyzed.Results The onset mode,clinical manifestation,imaging character and development of the 2 collected cases were similar,but the risk factors were different.Conclusion The mechanism,etiology of mixed stroke of bilateral successive cerebral hemorrhage with hematoma enlargement and brain stem infarction are complicated bilateral cerebrum anomalous structure,hemodynamics,change of vasoactive substance may all contribute to this kind of mixed stroke.There are various vascular risk factors,we should try to find the etiopathogenesis and take proper treatment.