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相關文獻
- CT-Angiographic Findings in an Ongoing Hemorrhage in a Hypertensive Intracerebral Hematoma--a Case Report
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題 名 | CT-Angiographic Findings in an Ongoing Hemorrhage in a Hypertensive Intracerebral Hematoma--a Case Report=即時出血的高血壓性腦出血患者之電腦斷層血管造影表徵--病例報告 |
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作 者 | 蘇泉發; 張玉麟; 陳新源; 陳逸文; 李超群; | 書刊名 | 慈濟醫學 |
卷 期 | 11:2 1999.06[民88.06] |
頁 次 | 頁183-189 |
分類號 | 416.14 |
關鍵詞 | 電腦斷層血管造影; 電腦斷層; 高血壓性腦內出血; 高血壓; Computed tomographic angiography; Computed tomography; Hypertensive intracerebral hematoma; Hypertension; |
語 文 | 英文(English) |
中文摘要 | 目的:使用迴旋式電腦斷層血管攝影,以快速注射對比劑及影像重新組合方式來 做血管造影,是最近發展出來之腦血管造影新方法,它提供另一種診斷腦血管疾病之非侵犯 性之檢查方式。吾人報告一罕見的急性出血之高血壓腦出血案例,利用腦部電腦斷層血管攝 影術來診斷其即時出血之狀況。病人及方法:患者為 38 歲男性,已有多年之高血壓病史, 突發右側肢體無力及失語症,在短時間內被送至本院急診室。一般性電腦斷層攝影顯示在左 大腦被殼區有一約 2x2x3 公分之腦血腫塊, 但並未造成明顯的腦組織壓迫或腦中線位移。 而在血腫間吾人可隱約發現一較淡之放射透亮區。因患者年齡較正常腦中風的年齡輕,遂進 行電腦斷層血管攝影檢查。結果:經原片之仔細檢視,吾人發現一正出血的亮點,可視為正 滲出的對比劑,並且經由三度立體影像組合,可見有一明亮的對比劑滲漏點,此顯示患者為 正在出血之案例。患者經送加護病房,在半小時內,意識轉變成深昏迷,且形成左側撞孔放 大。 經緊急施行開顱手術取出血腫塊,手術中評估,血塊量約為第一次電腦斷層量之 2 至 3 倍,手術後患者撞孔回復至正常。結論:重新組合之電腦斷層血管攝影術及其原電腦斷層 影像對正出血的高血壓性腦出血,極有診斷之價值,當病患正處在一危險情況時,此可做為 一般侵犯型的數位型減贅影腦血管或傳統式腦血管攝影外之另一種診斷腦血管出血的途徑。 |
英文摘要 | Objective: Helical computed tomography (CT) with rapid injection of contrast medium and angio graphic reconstruction is a recently developed technique. It provides a non-invasive alternative to study cerebral vascular lesions. We report a rare case of hypertensive intracerebral hematoma with ongoing hemorrhage shown using CT angiography (CTA). Patient and Method: A 38-year-old man with long-term hypertension was sent to our ER due to a sudden attack of right hemiplegia and aphasia. The patient was sent from his home to our ER within one hour. The unenhanced CT scan showed a 2x2x3 cm' hematoma located in the left putamen without significant cerebral compression or shifting. Results: A round radiolucent zone engulfed in the clotted hematoma was identified. One of the CTA source images (thin section of axial films) showed a contrast-enhanced bright spot which indicated hyperacute bleeding. In addition, the three-dimensional reconstruction in an anterio-posterior projection revealed extravasation of the contrast medium as afine bright spot. The patient was sent to the intensive care unit where he deteriorated within half an hour with dilatation of the left pupil and he became comatose. He was operated on immediately afterfinding signs ofherniation. The size of the hematoma, estimated under the operative microscope, was at least two times of that shown on the first CT films. The patient's pupils returned to be normal after the operation. Conclusions: Reconstructed CTA images and CTA source images seem to be valuable in the detection of hyperacute bleeding of hypertensive intracerebral hemorrhage. They can be used as an alternative to conventional cerebral angiography and digital subtraction angiography when a patient is in critical condition. |
本系統中英文摘要資訊取自各篇刊載內容。