Weisberg L A
Department of Neurology and Psychiatry, Tulane Medical School, New Orleans, LA 70112.
Stroke. 1988 Dec;19(12):1565-9. doi: 10.1161/01.str.19.12.1565.
Six alcoholic patients developed extensive cerebral hemispheric hemorrhages with both intraventricular and subarachnoid blood. All patients had evidence of liver damage, low platelet counts, and abnormal prothrombin and partial thromboplastin times. Four patients presented with seizures; in two of the four, these seizures were initially diagnosed as alcohol withdrawal seizures. Four patients were comatose with lateralizing neurologic deficit; two patients were comatose without lateralizing neurologic deficit, suggesting a metabolic encephalopathy. In one patient there was delayed neurologic deterioration. In all six patients, computed tomography showed large diffuse cerebral hemispheric hemorrhages, prominent intraventricular blood, and breakthrough into the subarachnoid spaces, which was confirmed by necropsy findings. There was marked mass effect but minimal surrounding edema. All six patients died. In three, autopsy showed no evidence of aneurysm, vascular malformation, neoplasm, or amyloid angiopathy and no arteriolar hypertensive changes.
六名酒精性患者出现广泛的大脑半球出血，伴有脑室内和蛛网膜下腔出血。所有患者均有肝损伤、血小板计数低以及凝血酶原和部分凝血活酶时间异常的证据。四名患者出现癫痫发作；在这四名患者中的两名中，这些癫痫发作最初被诊断为酒精戒断性癫痫发作。四名患者昏迷且有定位神经功能缺损；两名患者昏迷但无定位神经功能缺损，提示代谢性脑病。一名患者出现延迟性神经功能恶化。在所有六名患者中，计算机断层扫描显示大脑半球有大面积弥漫性出血、脑室内血液明显以及突破至蛛网膜下腔，尸检结果证实了这一点。有明显的占位效应，但周围水肿轻微。所有六名患者均死亡。在三名患者中，尸检未发现动脉瘤、血管畸形、肿瘤或淀粉样血管病的证据，也未发现小动脉高血压性改变。
