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脑出血与脑肿瘤均为常见的颅内疾患,然而两者同时存在较为罕见,国内尚未见报道。我院在收治的中风病人中发现3例,现报道如下。 例1 女,48岁。右耳鸣耳聋一年。无明显诱因突然头痛、呕吐、双眼凝视及意识丧失2小时左右即送郊区医病留观。CT示左顶后急性血肿,右小脑肿瘤。经降血压、脱水和止血等治疗3天后神志清醒,右上下肢轻瘫。15天后转我院。检查:血压17.3/10.7Kpa,神清,无失语,双视乳头鼻侧缘模糊,余颅神经未见异常。四肢肌张力较低,右上下肢肌力V_(0-),四肢共济运动尚正常,病理反射未引出。再次CT扫描:①右后颅窝脑膜瘤,5×6×4.8cm,与直窦和天幕均有密切关系,使四脑室变窄并推移向左前方,伴阻塞性四脑室以上中度脑积水;②左顶枕部血肿吸收期,增强扫描示血肿周围规则环状强化,与血肿高密度灶之间隔以一低密度带。4个月行后颅窝开颅术,发现肿瘤位于小脑后方硬膜,天幕下方,小脑被压向前方已萎缩,约6×6×4.8cm。完整摘除肿瘤,病理为纤维母细胞型脑膜瘤。
Intracerebral hemorrhage and brain tumors are common intracranial diseases, however both exist at the same time is relatively rare, has not been reported in China. Three cases of stroke patients admitted to our hospital, are reported below. Example 1 Female, 48 years old. Right tinnitus deafness year. No obvious incentive for a sudden headache, vomiting, staring eyes and loss of consciousness around 2 hours to send suburban medical observation. CT showed the top left acute hematoma, right cerebellar tumor. The blood pressure, dehydration and hemostasis and other treatment 3 days after conscious, upper right and lower extremity paresis. 15 days later transferred to our hospital. Check: blood pressure 17.3 / 10.7Kpa, Shen Qing, no aphasia, bilateral binocular nasal edge fuzzy, no abnormalities in the cranial nerves. Lower extremity muscle tension, upper right and lower limb muscle strength V_ (0-), limbs and atherosclerosis is still normal, pathological reflex did not lead. CT scan again: ① right posterior fossa meningioma, 5 × 6 × 4.8cm, and sinus and canopy are closely related to the narrowing of the fourth ventricle and shift to the left in front, with obstructive four-compartment above the moderate brain volume Water; ② left top of the occipital hematoma absorption period, an enhanced scan showed regular circular enhancement of the hematoma, and high-density hematoma interval to a low-density zone. 4 months after posterior craniotomy craniotomy found that the tumor is located behind the cerebrum dural, under the canopus, the cerebellum is compressed to the front has shrunk, about 6 × 6 × 4.8cm. Complete removal of the tumor, the pathology of fibroblastic meningioma.