尾状核出血20例分析  

Analysis of 20 cases of caudate hemorrhage

作　　者：屠永华[1] 王玉锦[1] 

机构地区：[1]第三军医大学附属西南医院神经内科,重庆400038

出　　处：《中国综合临床》2004年第4期315-317,共3页Clinical Medicine of China

摘　　要：目的　探讨尾状核出血的临床特征与CT的关系。方法　回顾分析 2 0例尾状核出血患者的临床资料。结果　尾状核头部型以头痛、呕吐伴颈项强直为主要表现 ,如不行头部CT检查极易误诊为蛛网膜下腔出血。尾状核体部局限型以头痛和轻、中度精神症状为主 ,呕吐和颈项强直少见。进展型以头痛呕吐 ,颈项强直和轻度偏瘫、意识障碍 ,并出现眼部体征。脑室穿破型以突发中、重度意识障碍起病 ,表现与原发脑室出血相似。两种局限型预后良好 ,进展型无一例死亡 ,但多留有轻度后遗症 ,脑室穿破型预后差 ,病死率高。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 ,而出现不同的临床特征。Objective To explore the relationship between CT and clinical characteristics of caudate hemorrhage.Methods 20 cases of caudate hemorrhage were retrospectively analyzed.Results Headache and nausea complicated with neck stiffness were the main clinical features in the head type of caudate,which would be misdiagnosed as subarachnoid hemorrhage without CT examination; Headache and slight and moderate psychiatric symptom other than nausea and neck stiffness were the main clinical features in the body limit type of caudate; Headache,nausea,neck stiffness and slight hemiplegia,disturbance of consciousness and sign of eye were the main clinical features in the progressive type of caudate; moderate and severe disturbance of consciousness caused cerebral ventricle performation type of caudate,which main features were the same as cerebral hemorrhage type.The prognosis was better in the two limit types but poor in cerebral ventricle performation with high fatality rate.There was no death in progressive type but mild sequela left.Conclusion Hemorrhage of caudate shows different clinical features according to hematoma limited to head,body of caudate or involved with adjacent tissue.

关 键 词：尾状核出血 影像学检查 

分 类 号：R743.34[医药卫生—神经病学与精神病学]