Ropper A H, Shafran B
Arch Neurol. 1984 Jan;41(1):26-9. doi: 10.1001/archneur.1984.04050130032017.
We studied prospectively the syndrome of brain edema after a large infarction in 12 patients. The major symptom was drowsiness, which began on the first to fourth day after the ictus and which was accompanied by asymmetry in pupillary size of 0.5 to 2.0 mm in eight patients, periodic breathing in seven, and Babinski's sign contralateral to the hemiparesis in five. These accompanying signs appeared several hours after drowsiness in some patients. Seven patients had brain death, one died of sepsis after recovering from brain swelling, and only four survived. In six patients in whom intracranial pressure was continuously measured, levels persistently above 15 mm Hg were associated with eventual brain death (four patients) and levels below 15 mm Hg were associated with survival (two patients).
我们对12例大面积脑梗死后脑水肿综合征进行了前瞻性研究。主要症状为嗜睡，于发病后第1至4天开始出现，8例患者伴有瞳孔大小不对称，相差0.5至2.0毫米，7例出现周期性呼吸，5例在偏瘫对侧出现巴宾斯基征。在一些患者中，这些伴随症状在嗜睡出现数小时后出现。7例患者发生脑死亡，1例在脑肿胀恢复后死于败血症，仅4例存活。在持续测量颅内压的6例患者中，颅内压持续高于15毫米汞柱与最终脑死亡（4例患者）相关，而低于15毫米汞柱与存活（2例患者）相关。
