顱內(nèi)血腫英文ppt課件-在線瀏覽
2025-02-21 23:36本頁面
【正文】 hemorrhage) ? Sudden onset while the patient is up and active CLINICAL PICTURE , nausea, vomiting of meningeal irritation(Stiff neck, Brudzinski sign, Kernig sign) CLINICAL PICTURE of consciousness, seizure most case, there is no local neurologic deficit except for third nerve palsy (occular movement disturbance) CLINICAL PICTURE delayed hemiplegia may occur 410 days after onset (attributed to vascular spasm). of fundi reveals preretinal or subhyaloid hemorrhage. LABORATORY FINDINGS : Bloody CSF(blood cells inside) 2. CT scan: detect blood in the subarachnoid space locally or diffusely. ? MRI angiography: demonstrates an aneurysm or AVM. DIAGNOSIS DiagnosisHeadache, vomiting + Meningitic symdrome + Bloody CSF Differential Diagnosis ? Meningitis ? Secondary subarachnoid hemorrhage ? Other types of stroke TREATMENT ? Stop bleeding, prevent vascular spasm, remove cause and prevent reoccurrence (in principle) TREATMENT bed rest for 46 weeks, relieve and stop pain, avoid making too strenuous efforts. for intracranial hypertension TREATMENT bleeding: EACA, PAMBA for 710 days. 4. Prevention and treatment for vascular spasm: Nimodipine TREATMENT operation ? Removal of the aneurysm or AVM. ? Intravascular approach is a good way. TREATMENT of recurrence: treatment for the cause, avoidance of inducement PROGNOSIS prognosis of ruptured aneurysm is grave, 30 percent of patients die at acute stage, 30 percent reoccurrence PROGNOSIS 2. The prognosis of ruptured AVM 3. Communicating hydrocephalus due to the disturbance of CSF absorption may appear after 24 weeks. ? decreased intelligence ? disorders of gait ? incontinence of urine SUMMARY OF ACUTE CEREBROVASCULAR DISEASE principles of diagnosis (1)sudden onsetstroke (2)extensive brain lesionshemorrhagic (3)local neurologic deficitsite of lesion (4) CT or MRIdefinite diagnosis SUMMARY principles of treatment (1)general management (2)dehydrant therapy (3)brain protective (4)hemorrhagic and ischemic stroke ? acute stage different ? late stage similar Which subtype of stroke has not paralysis at acute stage ? Cerebral hemorrhage ? Cerebral infarction ? Subrachnoid hemorrhage HEADACHE and MIGRAINE ? GENERAL CONSIDERATIONS term headache enpass the aches and pains located in th
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