尾状核出血  

Caudate Hemorrhage

作　　者：熊新英[1] 

机构地区：[1]兰州医学院附属一院,兰州730000

出　　处：《中国神经免疫学和神经病学杂志》1998年第4期214-219,共6页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的探讨见状核出血临床特征与CT的关系。方法总结40例尾状核出血病例并根据头CT血肿的部位将尾状核出血分成4种类型：见状核头部局限型、见状核体部局限型、进展型和脑室穿破型。结果见状核头部局限型以头痛、呕吐伴颈强直为主要表现，如不行头CT扫描极易误诊为蛛网膜下腔出血。见状核体部局限型以头痛和轻中度精神症状为主要表现，呕吐和颈强直少见。进展型则在头痛呕吐颈强直的基础上出现轻中度偏瘫和意识障碍，并轻易出现眼部体征。脑室穿破型临床以突发中重度意识障碍起病，临床表现与原发脑室出血相似。两种局限型预后良好，进展型无死亡病例但多遗留轻中度后遗症，脑室穿玻型预后至，死亡率高。结论尾状核出血依据血肿局限于尾状核头部、体部或波及邻近组织的不同，而有不同的临床特征。.The present study reports the cases of 40 patients with caudate hemorrhage,the relationshipe between the clinical and computed tomographic (CT) were described.Methods According to hemorrhage location by CT, caudate hemorrhage were divided into four types: limit type in the head of the caudate, limit type in the body of the caudate, extended type and the type of rupture into ventricles. Results The headache. nausea. vomiting with neck stiffness were the main clinical features of the limit type in the head of caudate. If the patients in this type had not be performed on CT scan, they would have been diagnosed as subrachnoid hemorrhage. The headache accompanied by some mental symptoms were the main clinical features of the limit type in the bode of caudate. Nausea. vomiting.neck stiffness were seen less common. On the basis of headache. vomiting and neck stiff ness with slight to moderate hemiplegia and disorder of consciousness were the clinical feature of the extended type. Serious consciousness confusion with vomiting.neck stiffness paralysis of four extremities and abnormal respiration were presented frequently in the type of rupture into ventricles. Patients in this type mimicked the primary intraventricular hemorrhage. The prognosis of two limit type was good. In the extended type, none of the them died, but 60%patient had slight to moderate residual neurological deficits. The prognosis in the type of rupture into ventricles was very poor. The mortality was veyr high. Conclution There were different clinical features in the four types of caudate hemorrhage.

关 键 词：尾状核出血 脑出血 CT 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]