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題 名 | Moyamoya Disease Causes Acute Subdural Hematomas and Sudden Death: A Case Report=Moyamoya疾病引起硬腦膜下腔出血及猝死:一病例報告 |
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作 者 | 沈戊忠; 李文源; | 書刊名 | 中華醫學雜誌 |
卷 期 | 61:10 1998.10[民87.10] |
頁 次 | 頁619-623 |
分類號 | 416.291 |
關鍵詞 | Moyamoya疾病; 硬腦膜下腔血腫; 猝死; Moyamoya disease; Subdural hematoma; Sudden death; |
語 文 | 英文(English) |
中文摘要 | 本文報告 1例因Moyamoya病,引起罕見的硬腦膜下腔出血,隨後出現腦血管梗塞 而死亡。此病例為59歲女性,因持續頭痛、嘔吐 5天而入院,神經學檢查發現有腦壓昇高現 象,CT顯示左側額頂顳區及右側額部硬腦膜下腔出血;腦血管攝影檢查發現左側中腦動脈和 前腦動脈完全阻塞,且有許多側枝循環,此乃典型的Moyamoya疾病。當時只採取保守療法。 5天之後,患者突然昏迷,再次CT顯示左側大腦半球廣泛性腦水腫合併�w回疝,10小時後不 治死亡。一般來說,Moyamoya病頸內動脈部份分枝雖完全阻塞,但靠眾多側枝循環,極少會 發生廣泛性大腦梗塞,我們懷疑此病例可能是硬腦膜下腔血腫壓迫硬膜下側枝循環導致大腦 梗塞,當時如及時清除硬腦膜下腔血腫,或許不會發生此不幸事件。 |
英文摘要 | A 59-year-old woman suffered from sudden onset of severe headach and vomiting for five days, with normal consciousness. A computerized tomography (CT) scan showed acute subdural hematomas in the right frontal and left frontotemporoparietal regions. As there was no history of head injury, the patient underwent bilateral carotid angiography. The left carotid angiogram showed total occlusion of the left middle cerebral and anterior cerebral arteries with a moyamoya pattern of collateral circulation. Five days later, the patient suddenly lost consciousness associated with right hemiparesis. An emergency CT scan disclosed diffuse acute brain tissue edema in the left cerebral hemisphere with uncal/transtentorial herniation, caused by acute infarction in the territory of the left middle cerebral artery. The patient died 10 hours later. The acute infarction was considered to have been caused by subdural hematomas compressing the transdural anastomoses, thus eliminating all blood supply to the region of the left middle cerebral artery. |
本系統中英文摘要資訊取自各篇刊載內容。