九例急性双侧半球大灶脑梗死的临床特点  

Report of nine cases of acute bihemispheric large brain infarction

作　　者：曲方[1] 周中和[1] 何凡[1] 张广生[1] 穆新宇 

机构地区：[1]沈阳军区总医院,沈阳110015 [2]辽阳市一五三厂医院

出　　处：《中华老年心脑血管病杂志》2008年第3期188-190,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨急性双侧半球大灶脑梗死的临床特点、预后及可能的发病机制。方法对9例急性双侧半球大灶脑梗死患者的危险因素、临床症状和体征、神经影像所见以及结局进行回顾性分析。结果所有患者均有高血压、糖尿病、心脏病等1种以上病史,曾患脑梗死6例。所有患者均表现意识障碍和四肢瘫痪。9例患者中,6例见双眼球水平徘徊,3例见双眼球向一侧凝视。头颅CT或MRI均显示双侧额、顶、颞叶或基底节区大片状低密度影或异常信号。5例死于脑疝或并发症,4例呈去皮质状态。结论9例急性双侧半球脑梗死系双侧颈内动脉或大脑中动脉支配区的大灶梗死,心源性或主动脉源性栓塞可能是主要的原因。其预后极差。Objective To explore the clinical features,prognosis,and possible pathogenesis of acute bihemispheric large brain infarction. Methods The medical records of nine patients with acute bihemispheric large brain infarction were reviewed for their risk factors, symptoms and signs, CT and MRI findings,and outcomes. Results All cases had at least one risk factor including hypertension,diabetes mellitus,and heart diseases,and six of them had cerebral infarction in the past. Consciousness disturbance and quadriplegia were present in all cases,restless eyes in six and conjugate eye deviation in the other. Head CT or MRI showed hypodense or abnormal signals in bilateral frontal, parietal and temporal lobes and/or basal ganglion regions. Five cases died of brain hernia or complication,and four still in decorticated state. Conclusion Acute bihemispheric brain infarction in these 9 cases was large infarcts localized in bilateral internal carotid artery or middle cerebral artery territories, strongly suggesting that cardiac or aortic embolism was the potential source. The prognosis of such cases was rather poor,either death or vegetable state survival.

关 键 词：脑梗塞 意识障碍 四肢麻痹 预后 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]