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真性红细胞增多症是一种比较少见的原因不明的慢性进行性的骨髓增殖症。缺血性脑血管病是此病常见的并发症之一,但同时合并脑出血的尚未见报导,现将我科收治的一例以脑血栓为首发症状后又合并脑出血的真性红细胞增多症病人报告如下: 男,37岁。于1990年9月28日因反应迟钝、语言错乱二周,右侧肢体活动欠灵一周入院。既往有血压增高病史一年(并未诊断高血压症)。查体:血压13.5/11kPa,神清,心、肺、腹未见异常。反应迟钝,思维能力差,定向力障碍,计算力降低,命名性失语。球结膜充血,口唇、面部、粘膜呈紫红色,双眼底视乳头边界清楚,动脉略变细,反光增强。右上下肢肌力Ⅴ。右手肌力Ⅳ。,右霍夫曼氏征阳性,左侧肌力正常。9月27日CT检查示左侧多发性脑梗塞。血HCT63.5％、RBC6.48×10~(12)/L、Hb188g/L,全血比粘度高切
Polycythemia vera is a relatively uncommon chronic myeloproliferative disorder of unknown cause. Ischemic cerebrovascular disease is a common complication of the disease, but at the same time, there have been no reports of cerebral hemorrhage, now we receive a case of cerebral thrombosis as the first symptom after combined with cerebral hemorrhage polycythemia vera The report is as follows: Male, 37 years old. On September 28, 1990 due to unresponsiveness, language disorder two weeks, the right side of the body ill-given one week hospitalization. Past history of hypertension increased one year (not diagnosed with hypertension). Physical examination: blood pressure 13.5 / 11kPa, God clear, heart, lung, abdomen no exception. Unresponsive, poor thinking ability, disorientation, reduced computational power, nominal aphasia. Bulbar conjunctiva hyperemia, lips, face, mucosa was purple, eyes clear end of the nipple clear boundary, arteries slightly thinner, reflective enhancement. Right upper limb muscle strength Ⅴ. Right hand muscle Ⅳ. Right Huffman’s sign positive, left normal muscle strength. September 27 CT examination showed multiple left cerebral infarction. Blood HCT63.5%, RBC6.48 × 10 ~ (12) / L, Hb188g / L, high specific viscosity of whole blood