Perez Jesus, Scherle Claudio, Machado Calixto
Hermanos Ameijeiras Hospital, San Lazaro 701, Havana, 10400, Cuba.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.04.2009.1734. Epub 2009 Jun 26.
Simultaneous or subsequent bilateral thalamic haemorrhage is rare, and most reported cases are from Asian countries. An 80-year-old white Cuban man, with a history of arterial hypertension, suffered sudden onset of right hemiparesis. Computed tomography (CT) scan showed a left posteromedial thalamic haemorrhage. Two days later his condition suddenly deteriorated: blood pressure was 220/105 mm Hg, he was stuporous and tetraplegic, respiration was ataxic, and his gaze was fixed and deviated downward and inward. CT scan showed haemorrhages in both thalami, extending to the ventricles. 32 h later the patient died. There are few previous publications of simultaneous or subsequent bilateral thalamic haemorrhages and this is the first report involving a Hispanic patient. Prognosis in patients with bilateral thalamic haemorrhage is poor, and the mechanism underlying the development of subsequent and symmetrical bleeding is not clear.
双侧丘脑同时或相继出血很少见，大多数报道的病例来自亚洲国家。一名80岁的古巴白人男性，有动脉高血压病史，突发右侧偏瘫。计算机断层扫描（CT）显示左侧丘脑后内侧出血。两天后，他的病情突然恶化：血压为220/105 mmHg，呈昏迷状态且四肢瘫痪，呼吸失调，目光固定并向下向内偏斜。CT扫描显示双侧丘脑均有出血，并延伸至脑室。32小时后患者死亡。之前关于双侧丘脑同时或相继出血的出版物很少，这是首例涉及西班牙裔患者的报道。双侧丘脑出血患者的预后很差，后续对称性出血发展的潜在机制尚不清楚。
