摘要
目的 探讨颅脑手术后并发急性缺血性脑卒中的病因、诊治和预防措施、预后.方法 回顾性分析2016年5月至2017年1月因颅脑损伤和高血压脑出血手术后并发急性脑梗死5例患者的术前情况、影像资料、手术情况、药物治疗、并发脑卒中情况、预后情况等,重型颅脑损伤2例;高血压脑出血骨窗开颅或钻孔血肿引流3例,其中1例为基底节大量脑出血并发脑疝术后6d复查CT发现枕叶急性梗死,1例为丘脑出血破入双侧脑室铸型术后8 d突发意识障碍加重经CT检查证实枕叶脑梗死;全部病例均存在误诊,缺血性脑卒中发现后采取措施不当.结果5例中植物生存1例,死亡4例.结论 颅脑手术后继发缺血性脑卒中易于延误诊治,一旦发生预后不良,及时防治甚为重要.
Objective To explore the etiology, treatment, prevention and prognosis of acute cerebral ischemic stroke after cranial cerebral operation. Methods Five cases with acute cerebral ischemic stroke after cranial cerebral operation between May 2016 and January 2017 were retrospectively analyzed. Pre-operation condition, image materials, operational process, chemotherapy, situation of ischemic stroke and prognosis was analyzed. Two cases received operation because of traumatic brain injury （TBI）. Three cases received operation because of hypertensive intra-cerebral hemorrhage （ICH）, among whom 1 case was diagnosed as acute occipital infarction by CT examination 6 d after operation of basilar massive hemorrhage complicalted with brain hernia, and 1 case was diagnosed as acute occipital infarction by CT examination 8 d after sudden unconsciousness and operation of thalamus hemorrhage complicated with jammed both lateral ventricles. All of the cases were misdiagnosed and mistreated. Results One case showed persisted vegetable state, and 4 cases were dead. Conclusions Acute cerebral ischemic stroke after cranial cerebral operation can be easily misdiagnosed and mistreated.Once it starts, and the prognosis is bad,meanwhile the timely prevention of it is vital.
出处
《中国医师进修杂志》
2017年第12期1126-1128,共3页
Chinese Journal of Postgraduates of Medicine
关键词
脑梗塞
颅脑损伤
卒中
预后
Brain infarction
Craniocerebral trauma
Stroke
Prognosis
