Kurokawa Y, Hashi K, Nakagawa T, Uede T, Shinya T, Fujishige M, Ishiguro M, Takamura Y
Department of Neurosurgery, Sapporo Medical College, Japan.
No To Shinkei. 1989 Aug;41(8):771-6.
Three cases of intracranial hematomas which showed a fluid level presentation and/or mixed density in the acute stage by X-ray CT were reported. Case 1 is a 7-year-old boy who had the epidural and intracerebral hematomas three hours after the traffic accident. During the course, intracerebral hematomas which showed a fluid-level presentation had grown both 6 and 17 hours after the episode. Case 2 is a 39-year-old female who had received an aortic valve replacement 20 years ago. She was diagnosed as cerebral infarction due to the occlusion of the right middle cerebral artery. Intracerebral hematomas with a fluid level presentation developed in the infarcted area 20 days after the embolectomy. Case 3 is a 67-year-old female who had a mild subarachnoid hemorrhage by the traffic accident. Intracerebral hematoma with mixed density developed 68 hours after the episode and it enlarged again 89 hours after the accident. All three cases showed the abnormalities in the coagulofibrinolytic activities during the hemorrhage and showed a growth of the hematomas. It should be noticed that the case which shows a mixed density and/or a fluid level presentation in the X-ray CT requires more intensive care in both neurosurgical and general management.
报告了3例颅内血肿病例，这些病例在X线计算机断层扫描（X-ray CT）的急性期表现为液平征和/或混合密度。病例1是一名7岁男孩，在交通事故发生3小时后出现硬膜外和脑内血肿。在此过程中，表现为液平征的脑内血肿在发病后6小时和17小时均有增大。病例2是一名39岁女性，20年前接受了主动脉瓣置换术。她被诊断为因右大脑中动脉闭塞导致的脑梗死。在取栓术后20天，梗死区域出现了有液平征的脑内血肿。病例3是一名67岁女性，因交通事故发生轻度蛛网膜下腔出血。发病后68小时出现混合密度的脑内血肿，事故发生89小时后血肿再次增大。所有3例在出血期间均显示出凝血纤溶活性异常，且血肿均有增大。应当注意的是，在X线CT中表现为混合密度和/或液平征的病例在神经外科和综合管理方面都需要更密切的监护。
