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[出血性中风的神经影像学诊断与治疗方面]

[Neuroimaging diagnosis and aspects of therapy of hemorrhagic stroke].

作者信息

Shmyrev V I, Arkhipov S L, Kuznetsova S E, Ternovoĭ S K

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2001;101(1):27-31.

Abstract

The peculiarities of the clinical manifestations of the hemorrhages into the brain were analyzed in 215 patients regarding both the degree of the blood break into the ventricular system and the size of the perifocal edema. It is demonstrated that the clinical picture, course and prognosis of the disease depend on the volume of the hemorrhage, the degree of the ventricular tamponage, presence of both acute occlusive hydrocephalus and secondary truncal syndrome. The presence of the blood in the ventricular system was not fatal, but, in some cases, led to the improvement of the patients' state because of the decrease of the voluminal influence of the hematoma. Therapy of patients with hemorrhagic strokes must be differential and be determined by the size of the perifocal edema in the ischemic tissue, the state of the system of the hemostasis as well as the presence of angiospasm of intracerebral vessels. Combined administration of calcium antagonists, antioxidants, antiedemic and antiprostaglandin preparations was grounded.

摘要

对215例脑内出血患者的临床表现特点进行了分析,涉及血液进入脑室系统的程度和灶周水肿的大小。结果表明,疾病的临床表现、病程和预后取决于出血量、脑室受压程度、急性梗阻性脑积水和继发性躯干综合征的存在情况。脑室系统内有血液并非致命,但在某些情况下,由于血肿体积影响的减小,反而导致患者病情改善。出血性中风患者的治疗必须个体化,取决于缺血组织灶周水肿的大小、止血系统的状态以及脑内血管痉挛的存在情况。联合使用钙拮抗剂、抗氧化剂、抗水肿和抗前列腺素制剂是有依据的。

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