论文部分内容阅读
1 临床特点 中老年女性,既往有高血压病史,情绪激动后突发头晕,随即不语、四肢瘫痪、饮水有呛咳、有吞咽困难和大小便失禁。查体:神志清楚,能通过睁、闭眼回答是与否,眼球的水平运动受限,双侧面瘫、舌瘫、延髓麻痹和四肢瘫,双侧巴氏征(+)。脑CT示:桥脑基底部低密度灶。 2 诊断 闭锁综合征、桥脑梗塞、高血压病(Ⅲ)。 3 鉴别诊断 ①无动性缄默症(又称睁眼昏迷):由于上行网状激活系统部分损害引起,大脑半球及其传出通路则无病变。可表现为缄默、肢体无自发性活动,但强刺激时有逃避反应,能睁眼,眼球有追物动作,无表
1 Clinical features Middle-aged women, with previous history of hypertension, sudden dizziness after emotional excitement, then without language, paralyzed limbs, drinking cough, difficulty swallowing and incontinence. Physical examination: Consciousness, through the eyes, eyes closed to answer yes or no, limited horizontal eye movement, bilateral paralysis, tongue paralysis, bulbar paralysis and quadriplegia, bilateral Pakistan's sign (+). Brain CT showed: pons base low density lesions. 2 diagnosis of atresia syndrome, pontine infarction, hypertension (Ⅲ). 3 differential diagnosis ① inadvertent mutism (also known as open eyes unconsciousness): due to some damage caused by the uplink reticular activation system, the cerebral hemisphere and its outgoing path without lesions. Can be expressed as silence, limbs without spontaneous activity, but the strong stimulation to avoid reaction, can be open eyes, the eye has a chase movement, no table