Caplan L R, Goodwin J A
Neurology. 1982 Mar;32(3):252-60. doi: 10.1212/wnl.32.3.252.
Hypertension intracerebral hemorrhages are caused by leakage from small penetrating branches of larger cerebral vessels. In the brainstem, these vessels penetrate in a median, paramedian, and more lateral orientation. As illustrated by three patients reported here, hemorrhage from the lateral vessels may be limited to the lateral tegmentum, or spread to the dorsal basis pontis. The syndrome is relatively consistent and includes (1) ipsilateral conjugate gaze palsy, (2) ipsilateral internuclear ophthalmoplegia, (3) small reactive pupils with a smaller pupil ipsilateral to the lesion, (4) limb ataxia of the cerebellar type (often greater ipsilaterally), (5) contralateral hemiplegia, and (6) contralateral severe hemisensory loss. Patients frequently survive after lateral tegmental hemorrhages, which can be diagnosed by CT.
高血压性脑出血是由大脑较大血管的小穿支渗漏引起的。在脑干中，这些血管呈中线、旁中线和更外侧的方向穿行。正如这里报告的三名患者所示，外侧血管出血可能局限于外侧被盖，或蔓延至脑桥背侧基底部。该综合征相对一致，包括：（1）同侧共轭凝视麻痹；（2）同侧核间性眼肌麻痹；（3）小而有反应的瞳孔，病变同侧瞳孔较小；（4）小脑型肢体共济失调（通常同侧更明显）；（5）对侧偏瘫；（6）对侧严重半身感觉丧失。外侧被盖出血的患者通常能存活，可通过CT诊断。
