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作者对细菌性脑膜炎(BM)并发脑血管病(CVD)的预后、类型、频率及表现作了前瞻性研究。86例成人患者临床及脑脊液检查均符合 BM。其中27例有偏瘫、局限性癫痫,头部 CT 显示梗塞或局灶水肿,应用抗生素治疗3天仍昏迷而行脑血管造影术(CA)。病原学检查;60例脑脊液中检出病原菌,其中半数为肺炎双球菌,另有少数淋球菌、金黄色葡萄球菌及流感病毒等。CA 的主要改变有:(1)脑基底部动脉:颈内动脉床突上段狭窄3例,大脑后动脉闭塞1例。(2)中等大小动脉:大脑中动脉分支管壁不规则狭窄扩张3例。(3)小血管:局灶充血伴早期静脉充盈,造影剂滞留于毛细血管。(4)大静脉窦和皮层静脉栓塞:上矢状窦、皮层静脉不显影各2例。CA 显示脑血管井发症(CVC)的13例中7例头部 CT 示脑梗塞。CA
The authors prospectively studied the prognosis, type, frequency and performance of bacterial meningitis (BM) complicated with cerebrovascular disease (CVD). 86 cases of adult patients with clinical and cerebrospinal fluid examination are in line with BM. 27 cases had hemiplegia, partial epilepsy, head CT showed infarction or focal edema, three days of antibiotic treatment was still coma and cerebral angiography (CA). Pathogenetic examination; 60 cases of cerebrospinal fluid in the detection of pathogens, of which half of Streptococcus pneumoniae, while a small number of Neisseria gonorrhoeae, Staphylococcus aureus and influenza virus. The main changes of CA are: (1) basilar artery: 3 cases of stenosis of upper internal carotid artery and 1 case of posterior cerebral artery occlusion. (2) medium-sized artery: middle cerebral artery branch wall irregular stenosis in 3 cases. (3) small blood vessels: focal congestion with early venous filling, contrast agent retention in the capillaries. (4) large sinus and cortical vein embolism: the superior sagittal sinus, cortical vein does not develop in 2 cases. Seven of the 13 patients with cerebrovascular disease (CVC) who showed cerebral CT showed cerebral infarction. CA