Toyoda K, Kumai Y, Fujii K, Ando T, Ibayashi S
Stroke Centre, Fukuoka Red Cross Hospital, Fukuoka, Japan.
J Neurol Neurosurg Psychiatry. 2002 May;72(5):673-4. doi: 10.1136/jnnp.72.5.673.
Primary brain haemorrhage and infarction only very rarely occur simultaneously. A patient with end stage renal disease from diabetic nephropathy suddenly had motor aphasia and horizontal nystagmus soon after finishing haemodialysis. Neuroradiological studies showed a haematoma on the right side of the pons and an infarct in the left frontal lobe with occlusion of the left internal carotid artery. Specific conditions of the haemodialysis--including anticoagulant use, relative hypovolaemia and hypertension just before haemodialysis, and an abrupt decrease in blood pressure during haemodialysis--seemed to be the major reason for the simultaneous onset of dual strokes.
原发性脑出血和梗死极少同时发生。一名患有糖尿病肾病所致终末期肾病的患者在完成血液透析后不久突然出现运动性失语和水平性眼球震颤。神经放射学检查显示脑桥右侧有血肿，左侧额叶有梗死灶，左侧颈内动脉闭塞。血液透析的特定情况——包括抗凝剂的使用、血液透析前相对血容量不足和高血压以及血液透析期间血压突然下降——似乎是双发性卒中同时发作的主要原因。
