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头部外伤所致颅内外血管并发症中,大脑前动脉闭塞较罕见。现报告本院2例,并分析讨论之。 [例1]男,40岁。住院号7535。1985年11月20日酒后骑自行车跌倒,伤及头部,爬起时感觉头痛,以前额为甚,并恶心,呕吐,视物模糊,左下肢乏力。伤后第4天头痛加剧,右眼胀痛,频繁呕吐,偶有大小便失禁。查体:意识清楚。右额及颧部皮肤擦伤。眼底视乳头水肿。左下肢肌力Ⅵ级,肌张力减弱。头颅平片示右前颅窝经颞部向后上斜行线状骨折。脑脊液血性,压力2.54KPa。诊断:脑挫裂伤,颅底骨折。经综合治疗7天,患者仍诉头痛、差明,偶有尿失禁。右颈总动脉造影见大脑前动脉未显影,大脑中、后动脉形态正常。4天后再行右颈总动脉造影,注入造影剂的同时压迫左侧
Head injury due to intracranial and extracranial vascular complications, occlusion of the anterior cerebral artery is relatively rare. Now report two cases in our hospital, and analyze and discuss. [Example 1] Male, 40 years old. Hospital number 7535. November 20, 1985 drunk bike ride down, hurt the head, get up feeling a headache, the forehead is even, and nausea, vomiting, blurred vision, left lower extremity fatigue. Headache aggravated on day 4 after injury, with pain in the right eye, frequent vomiting, and incidental incontinence. Physical examination: a clear sense. Right frontal and zygomatic skin abrasions. Ocular papilledema. Left leg muscle strength Ⅵ level, muscle tone weakened. Skull plain film shows the right anterior cranial fossa oblique oblique line by the temporal back line fracture. Cerebrospinal fluid bloody, pressure 2.54KPa. Diagnosis: cerebral contusion, skull fracture. After seven days of comprehensive treatment, patients still complained of headache, poor, occasional urinary incontinence. Right common carotid artery angiography showed no anterior cerebral artery imaging, the brain, the posterior artery morphology is normal. After 4 days, the right common carotid artery angiography was performed, and contrast agent was infused while pressing the left