Ruff R L, Dougherty J H
Neurology. 1981 Jun;31(6):736-40. doi: 10.1212/wnl.31.6.736.
Of 217 patients with clinical diagnosis of acute stroke 23% had nonischemic lesions diagnosed by computed tomography (CT) or lumbar puncture (LP). CT demonstrated all 37 cases of intracerebral hemorrhagic lesions; 9 were detected by LP. CT failed to demonstrate 8 of 17 cases of subarachnoid hemorrhage, but only 1 of these lacked headache or stiff neck. In 7 of 342 patients who were treated with anticoagulants after LP, spinal hematoma followed LP ( 5 with paraparesis). CT evaluation reduced the incidence of fatal cerebral hemorrhage during anticoagulant therapy of acute stroke. However, even if patients were evaluated with both CT and LP, the incidence of fatal cerebral hemorrhage resulting from intravenous anticoagulant therapy was 2.4%.
在217例临床诊断为急性中风的患者中，23%经计算机断层扫描（CT）或腰椎穿刺（LP）诊断为非缺血性病变。CT显示了所有37例脑内出血性病变；9例通过LP检测到。CT未能显示17例蛛网膜下腔出血中的8例，但其中只有1例没有头痛或颈部僵硬。在342例LP后接受抗凝治疗的患者中，7例出现了脊髓血肿（5例伴有下肢轻瘫）。CT评估降低了急性中风抗凝治疗期间致命性脑出血的发生率。然而，即使对患者进行了CT和LP评估，静脉抗凝治疗导致的致命性脑出血发生率仍为2.4%。
