大脑动脉闭塞的CT诊断(附36例分析)

目的：旨在提高大脑动脉闭塞的CT诊断水平。材料与方法：对36例临床上诊断或怀疑有脑梗塞、脑溢血、转移性肿瘤、脑脓肿等患者作CT平扫，有的作2～4次。其中6例作增强扫描。结果：大脑中动脉闭塞25例，其中7例引起出血性脑梗塞；大胸前动脉闭塞6例；大脑后动脉闭塞1例；大脑中动脉和前动脉均闭塞2例；既有大脑中动脉闭塞，又有大脑后动脉出血1例：开始为腔隙性脑梗塞，后又有大脑前动脉闭塞1例。结论：1、大脑动脉闭塞，特别是有出血性脑梗塞的临床表现与脑溢血常混淆，即使是有经验的神经内科医师有时也要引起误诊。2、用窄窗观察和CT追踪复查是显示缺血性脑梗塞和出血性脑梗塞的重要手段。3、当临床表现不能由腔隙性脑梗塞作出解释时，应再作CT复查，看是否还有大脑动脉闭塞引起缺血性脑梗塞。4、出血性脑梗塞往往发生于缺血性脑梗塞后2周左右，因此必须进行CT复查。5、引起大脑动脉闭塞的原因很多，必须结合临床资料才能明确。

CT Diagnosis of Cerebral Arteries Occlusion (Analysis 36 Cases)

Purpese: Improve the CT diagnosis of cerebral arterial occlusion. Materials and Methods: We scanned plain film to 36 cases which diagnosised or suspected the cerebral infarction, encephalorrhagia, metastasis or pyencephalus in clinic. Some scanned 2 ~ 4 times. 6 cases make the enharced CT. Results: The cerebral middle arterial occlusion (25 cases). Include of bemorrhagic cerebral infarction (7 cases); The anterior arterial occlusion (6 cases). The posterior artery occlusion (1 case). The anterior and middle arteryial occlusion (2 cases). The middle arterial occlusion and the posterior arterial hemorrhagia (1 case). The beginning is the lacuna infarction, then the anterior anterial infarction (1 case). Conclusion: 1. The cerebral arterial occlusion, especialy the cerebral hemorrhagic infarction confused with the cerebral arterial hemorrhgia in chinic. 2. It is the important method to display the ischeme cerebral infarction and hemorrhagic infarction with narrow window and CT follow up study. 3. When the diagnosis of the lacuna infarction can not correspond the clinic appearance. It should reexamination to find the ischemic cerebral infarction. 4. It must reexaminate because the hemorrhagic infarction often occur after 2 weeks following the ischemic infarction. 5. To confirm the diagnosis must combine with clinic information because of the many camse due to the cerebral occulsion.