急性双侧半球支配区脑梗死15例临床分析  

Acute bihemispheric cerebral infarctions:Clinical analysis of 15 cases

作　　者：曲方[1] 刘保印 何凡[1] 周中和[1] 

机构地区：[1]沈阳军区总医院神经内科,辽宁沈阳110840 [2]彰武县第四人民医院神经内科,辽宁阜新123200

出　　处：《中风与神经疾病杂志》2012年第7期622-623,共2页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨急性双侧大脑半球梗死的临床特点、预后及发病机制。方法对15例急性双侧半球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病、糖尿病、心脏病、脑梗死等2种或2种以上疾病,主要表现为突发意识障碍、眼球运动异常以及四肢瘫痪。头部CT或MRI显示双侧额、顶、颞叶或基底节大片状低密度影或异常信号。9例死于脑疝,1例死于颅外并发症,5例出院时呈去皮质状态。结论本文报道15例急性多发性双侧半球梗死系双侧颈内动脉或大脑中动脉的支配区梗死,心源性或主动脉源性栓塞可能是主要的原因。本病预后极差,死亡或植物生存。Objective To explore the clinical features,prognosis,and possible pathogenesis of acute bihemispheric cerebral infarctions. Methods The medical records of 15 patients were reviewed for their risks,symptoms and signs,CT and MRI findings, and outcomes. Results All 15 cases had two or mere risk factors including hypertension,diabetes mellitus,heart diseases and cere- bral infarction in their past histories. The conscious disturbance,eye movement abnormality and quadriplegia were presented in all ca- ses. Head CI＂ or MRI showed hypodense or abnorwal signals siroaxltaneously in bilateral frontal,occipital and temporal and/or basal ganglion regions. Nine cases died of brain hernia and one of the complications,and the other five patients were in decorticated state when discharged. Conclusion Acute bihemispheric cerebral infarctions reported in the paper were large territorial infarcts localized in bilateral internal carotid arteries or middle cerebral arteries＇ regions ,strongly suggesting cardiac and aortic embolisms as potential sources. The prognosis of such cases was extremely poor ,either dead or vegetable survival.

关 键 词：急性多发性脑梗死 双侧大脑半球 大灶脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]