脑梗塞继发脑干出血的病理与临床  

Brain stem hemorrhage secondary to cerebral infarction: Clinical and pathological study

作　　者：徐惠琴[1] 罗翌 王耀山[1] 牛平[1] 曲方[1] 张景华[1] 何祥[1] 吕文斌[1] 

机构地区：[1]沈阳军区总医院神经内科,110015

出　　处：《中风与神经疾病杂志》1999年第1期21-23,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：探讨脑梗塞继发脑干出血的临床、ＣＴ、病理学特点及其发病机理。方法１０３例连续尸解脑梗塞病例中，经病理检查发现１１例继发脑干出血，分析其临床、ＣＴ及病理检查结果。结果脑梗塞继发脑干出血的临床特点是发病急、进展快、昏迷、四肢瘫、过高热及呼吸衰竭，ＣＴ一般不能发现脑干高密度病灶，病理结果均为半球大病灶脑梗塞，严重海马回疝致脑干严重受压、变形和移位，继发脑干出血以中脑为主，可累及桥脑，主要位于中线部位。结论脑梗塞继发脑干出血是由于严重脑干受压、变形导致脑干微小穿动脉、静脉及毛细血管被牵拉、破裂所致。Objective To investigate the clinical, CT, pathological feature and pathogenic mechanism of secondary brain stem hemorrhage following cerebral infarction. Method Pathological data,CT, relevent clinical materials were analysed. Results The clinical manifestation of brain stem hemorrhage secondary to cerebral infarction included sudden onset, evelution abruptly, coma, quadriplegia,higher fever and respiratory failure. CT usually do not identify the high dense location of brain stem.Large infarction of cerebral hemisphere may lead to shift the brain laterally and downward to produceherniation with subsequent brain stem compression, shift and distortion. Secondary brain stem hemorrhage occured usually in midderline area of midbrain or pontine. Conclusion Secondry brain stem hemorrhage is caused by severe brain stem compression and distortion with penetrating microartery, vein,capillary distorted and disrupted.

关 键 词：脑梗塞 继发性 脑干出血 脑疝 病理学 

分 类 号：R743.330.6[医药卫生—神经病学与精神病学] R743.340.2[医药卫生—临床医学]