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笔者搜集蛛网膜下腔出血后继发脑梗塞一例,就其CT表现报道如下: 患者男,60岁。突发性剧烈头痛伴呕吐继而意识障碍3小时入院。既往有高血压病史。查体:呈浅昏迷,脑膜刺激征阳性,无定位体征。眼底检查见双侧视乳头水肿。CT检查为蛛网膜下腔出血(SAH),按SAH治疗后病情好转;于入院后14天病情加重,再度昏迷。再次CT检查为蛛网膜下腔出血后继发脑梗塞,经抢救治疗无效死亡。 首次CT平扫显示:诸脑沟及脑池普遍密度增高,鞍上池、侧裂池、纵裂池及脑干包围池呈铸型高密度影,第四脑室亦见积血,诸脑室未见扩大;弥漫性脑肿胀,脑实质内未显示其它病灶;未见明显动脉瘤及血管畸形征象。CT诊断为SAH。入院第14天再次CT显示:在相同的部位仍有部分积
The author collected a case of secondary cerebral infarction after subarachnoid hemorrhage, reported on its CT findings are as follows: Male patient, 60 years old. Sudden severe headache with vomiting then unconsciousness 3 hours admission. Past history of hypertension. Physical examination: light coma, positive meningeal irritation, no signs of orientation. Fundus examination revealed bilateral papilledema. CT examination for subarachnoid hemorrhage (SAH), according to SAH treatment improved; in 14 days after admission, the disease aggravated again coma. CT scan again after subarachnoid hemorrhage secondary to cerebral infarction, died of rescue treatment ineffective. The first CT scan showed: the brain and brain pool sulci generally increased density, saddle pool, side split pool, longitudinal split pool and brainstem pool was cast high density, also see the fourth ventricle hemorrhage, See expansion; diffuse brain swelling, brain parenchyma did not show other lesions; no obvious signs of aneurysms and vascular malformations. CT diagnosis of SAH. On the 14th day of admission, CT again showed that there was still some product in the same site