共查询到20条相似文献,搜索用时 46 毫秒
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《中国神经免疫学和神经病学杂志》2019,(2)
<正>1 病例报告患者64岁,男性,主因"头晕8 d"入院。患者于入院8 d前无明显诱因出现头晕、恶心症状,伴口角及四肢麻木感,无天旋地转感,无视物模糊、视物成双,无耳聋耳鸣及听力下降,无胸闷、胸痛、气短等症状,自行服用硝苯地平片,症状未见明显缓解,于当地医院行头颅CT示左侧基底节区腔隙性脑梗死。查电解质示:钠124 mmol/L。给予小牛血注射液等药物治疗后,症状减轻出院。出院1 d后患者头晕、恶心及双手麻木等症状加重,进食水后呕吐,呈 相似文献
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病历摘要
患者女性,41岁。主诉直立后头晕、恶心、呕吐2周,于2009年11月2日入我院治疗。患者于入院前2周无诱因出现直立后头晕、黑蒙,平卧休息症状可消失,并开始出现恶心、呕吐,呕吐3~4次/d,为胃内容物,伴呃逆,无腹痛、腹泻。8d前在行走过程中突然晕倒,自述意识丧失,约1min后自行清醒,发作时无四肢抽搐、大小便失禁,此后多次出现晕厥,均发生于直立体位时。 相似文献
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正1病例报告患者女,78岁。主因"视物成双1d"于2017-03-01入院。1d前无明显诱因出现视物成双,向左侧注视时为著,伴头晕、恶心、呕吐,无耳鸣,头晕为持续性,与视物成双相关,闭眼后头晕可缓解。无肢体麻木及感觉异常,无肢体活动障碍,无言语不利、声音嘶哑、饮水呛咳等,无耳聋耳鸣,无出汗异常,无意识障碍及大小便障碍。既往2型糖尿病史9年余,平素口服二甲双胍0.5g,2次/d,血 相似文献
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患者男性,49岁。主因突发头晕2d,言语不清、四肢无力1d,于2013年5月7日入院。患者于入院前2d晨起无明显诱因突发头晕伴恶心、呕吐,无视物旋转、肢体无力,症状持续存在,未予处理。入院前1d出现言语不清、饮水呛咳,四肢无力,以左侧显著,并逐渐出现嗜睡。发病后6h至我院急诊就诊,头部MRI检查显示双侧延髓内侧梗死。 相似文献
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The anterior choroidal artery has several kinds of variations. Among them, the transposition of anterior choroidal artery and posterior communicating artery origins has been extremely rare. We report a case with cerebral aneurysm arising from posterior communicating artery which origin was distal to the anterior choroidal artery and review the relevant literature. 相似文献
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Jun Kyeung Ko Sang Weon Lee Tae Hong Lee Chang Hwa Choi 《Journal of Korean Neurosurgical Society》2009,46(5):488-491
A 31-year-old man presented with right hemiparesis, and magnetic resonance imaging revealed a small infarct at left basal ganglia. Digital subtraction angiography showed left cervical internal carotid artery (ICA) occlusion and severe stenosis of the ipsilateral external carotid artery (ECA) with collateral cerebral circulation fed by ECAs. Based on the results of a functional evaluation of cerebral blood flow, we performed preventive ECA angioplasty and stenting for advanced ECA stenosis to ensure sufficient blood flow to the superficial temporal artery. Eight weeks later, superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis was performed. His postoperative course was uneventful and no additional transient ischemic attacks have occurred. To our knowledge, this is the first report of preventive angioplasty and stenting for advanced narrowing of an ECA before STA-MCA anastomosis for ipsilateral ICA occlusion. 相似文献
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《Journal of stroke and cerebrovascular diseases》2022,31(5):106346
BackgroundCervical Artery Dissection is an important cause of stroke in the young. Data on incidence and associations of recurrence in patients with cervical artery dissection are lacking. Increased Vertebral Artery Tortuosity Index has been reported in patients with cervical artery dissection and associated with earlier age of arterial dissection in patients with connective tissue disease.ObjectiveTo test the hypothesis that increased vertebral artery tortuosity is associated with recurrent cervical artery dissection.MethodsWe reviewed data from a single-center registry of cervical artery dissection patients enrolled between 2011-2021. CT angiography was reviewed for neck length, vertebral artery dominance, and vertebral artery tortuosity index. Incidence rate of recurrent dissection was calculated using Poisson regression. Differences between groups were analyzed using the Kruskal-Wallis rank sum test and Fisher's exact test.ResultsThe cohort included 155 patients: women (56%), mean (SD) age 42 (±10) years, and 116 single and 39 multiple artery dissections. Eleven (7.1%) had a recurrence with an incidence rate (95% CI) of 1.91 (1.06, 3.44) per 100 person-years. Vertebral artery tortuosity did not differ significantly between single and recurrent groups (median (IQR) 46.81 (40.85, 53.91) vs 44.97 (40.68, 50.62) p = 0.388). Morphometric characteristics of height, neck length, and BMI were not associated with recurrence. There was no difference in vertebral artery tortuosity by dissection location (carotid vs vertebral).ConclusionIn this single center cohort of patients with cervical artery dissection, there was no difference in VTI between single and recurrent groups. 相似文献
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目的 寻找脑动脉夹层相关卒中复发的高风险影像学特征,探讨责任动脉闭塞与其复发的关系。方法 前瞻性连续性纳入2018年1月-2022年2月在郑州大学第一附属医院住院的首发脑动脉夹层相关卒中患者,通过MRI、MRA、CTA、HR-MRI及DSA等影像学方法评估血管闭塞、长节段夹层等影像学特征,长期随访其复发情况。通过单因素、多因素COX回归分析其复发的影响因素,构建Kaplan-Meier生存曲线评估血管闭塞与脑动脉夹层相关卒中复发的关系。结果 共纳入107例脑动脉夹层相关卒中患者,有10例(9.3%)患者复发。单因素及多因素COX回归分析提示,责任动脉闭塞是脑动脉夹层相关卒中复发患者预后不良的独立预测因子(HR 6.150,95%CI 1.227~30.810,P=0.027),出血转化也与脑动脉夹层相关卒中复发显著相关(HR 12.605,95%CI 2.373~66.949,P=0.003)。Kaplan-Meier生存曲线提示,闭塞组与非闭塞组卒中复发率差异具有统计学意义(Log-rank P=0.001)。结论 责任动脉闭塞是脑动脉夹层相关卒中复发的危险因素,需要大样本研究进一步验证本研究结果,为二级预防提供更精准的帮助。 相似文献
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Christina M. Burch Marcella A. Wozniak Michael A. Sloan Michael I. Rothman Daniele Rigamonti Thomas Permutt Yuji Numaguchi 《Journal of neuroimaging》1996,6(1):8-15
Little is known about the accuracy of transcranial Doppler (TCD) sonography in detecting intracranial internal carotid artery (IICA) and middle cerebral artery (MCA) vasospasm. TCD was performed in 49 patients with subarachnoid hemorrhage to evaluate 90 IICAs and 87 MCAs during the vasospasm period. When a mean velocity of at least 90 cm/sec was used to indicate IICA vasospasm, there were 11 positive, 42 negative, 4 false-positive, and 33 false-negative results. Sensitivity was 25% and specificity was 93%. When a mean velocity of at least 120 cm/sec was used to indicate MCA vasospasm, there were 15 positive, 45 negative, 3 false-positive, and 24 false-negative results (15 operator errors). Sensitivity was 38.5% and specificity was 93.7%. When the diagnostic criterion was changed to at least 130 cm/sec, specificities were 100% (IICA) and 96% (MCA) and positive predictive values were 100% (IICA) and 87% (MCA). The authors conclude that TCD accurately detects IICA and MCA vasospasm when flow velocities are at least 130 cm/sec. However, its sensitivity may be underestimated and the importance of operator error, overestimated. 相似文献