Pascuzzi R M, Boyko O B, Voelker J L
Department of Neurology, Indiana University Medical Center, Indianapolis.
J Comput Assist Tomogr. 1989 Sep-Oct;13(5):899-902. doi: 10.1097/00004728-198909000-00029.
A 72-year-old woman with previously symptomatic internal carotid artery occlusion subsequently presented with an acute hemispheric deficit. The patient was initially diagnosed as having an ischemic infarction but eventually was shown to have a subacute subdural hematoma with delay in surgical evacuation and a major permanent deficit. We speculate that internal carotid artery occlusion may predispose the patient to greater morbidity from subdural hematoma. Patchy hemispheric infarction may reflect greater vulnerability to extrinsic hemispheric compression in the setting of carotid occlusion. This case illustrates the necessity for vigorous pursuit of the diagnosis of subdural hematoma in patients presumed to have transient ischemic attacks or acute cerebral infarction.
一名72岁女性，既往有症状性颈内动脉闭塞，随后出现急性半球性缺损。患者最初被诊断为缺血性梗死，但最终发现有亚急性硬膜下血肿，手术清除延迟，遗留严重永久性缺损。我们推测颈内动脉闭塞可能使患者更容易因硬膜下血肿而出现更高的发病率。斑片状半球梗死可能反映在颈动脉闭塞情况下对外源性半球压迫的易感性增加。该病例说明，对于疑似短暂性脑缺血发作或急性脑梗死的患者，必须积极追查硬膜下血肿的诊断。
