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[小脑梗死中的梗阻性脑积水]

[Obstructive hydrocephalus in cerebellar infarcts].

作者信息

Busse O, Laun A, Agnoli A L

出版信息

Fortschr Neurol Psychiatr. 1984 May;52(5):164-71. doi: 10.1055/s-2007-1002014.

Abstract

Large cerebellar ischaemic infarction may act as a space-occupying lesion and cause acute ventricular dilatation secondary to brain stem compression. 8 cases are regarded and the clinical course and therapy are discussed. After acute onset with vestibular and cerebellar symptoms, signs of progressive clouding of consciousness, accompanied often by signs of brain stem compression develop leading finally to decerebration syndrome. CT reveals an extensive hypodense area, usually in the lower part of the cerebellar hemisphere, compression and shift of the IVth ventricle and dilatation of 3rd and lateral ventricles. Drainage of ventricular fluid alone is not sufficient and the therapy of choice is the resection of infarcted tissue. Even in patients, who were operated in the early phase of decerebration excellent recovery was noted.

摘要

大面积小脑缺血性梗死可作为占位性病变,继发脑干受压导致急性脑室扩张。本文回顾了8例病例并讨论了其临床过程及治疗方法。急性起病时出现前庭和小脑症状,随后出现意识进行性模糊的体征,常伴有脑干受压体征,最终发展为去大脑综合征。CT显示广泛的低密度区,通常位于小脑半球下部,第四脑室受压移位,第三脑室和侧脑室扩张。单纯引流脑脊液是不够的,首选治疗方法是切除梗死组织。即使是在去大脑早期接受手术的患者,也观察到了良好的恢复情况。

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