摘要
目的 探讨毒蛇咬伤致急性脑梗死的CT和MRI表现特征。方法 对7例毒蛇咬伤致急性脑梗死的影像学表现结合文 献进行回顾性分析。结果 7例患者,2例五步蛇咬伤,4例蝰蛇咬伤,1例不明毒蛇咬伤。大脑一叶或多叶脑组织 内多发散在分布的斑点状、斑片状、片状急性脑梗死。7例共21个脑叶84个急性脑梗死病灶,其中顶叶7个26个 病灶(26/84,30.95%)、额叶6个19个病灶(19/84,22.62%)、枕叶4个21个病灶(21/84,25%)、颞叶3个16个病灶 (16/84,19.05%)、基底节1个2个病灶(2/84,2.38%),1例合并脑内出血。结论 结合毒蛇咬伤史,CT和MRI检查对 毒蛇咬伤致急性脑梗死可明确诊断,并明确有无出血,对临床治疗方案提供有价值的信息。
Objective To determine the CT and MRI findings of acute cerebral infarction by venomous snake bitten. Methods The imaging findings of 7 patients with acute cerebral infarction by venomous snake bitten were analyzed retrospectively with literatures review. Results 2 case was bitten by Pit viper. 4cases were bitten by Russell's viper and 1 case was unknown viper. One leaf or multiple leaves cerebrum occurred frequently. Acute obstruct with multiple mottling, patchy, or schistose. 84 acute cerebral infarction in 21 leaves cerebrum of 7 cases, parietal lobe(26/84,30.95%),frontal lobe(19/84,22.62%),occipital lobe(21/84,25%),temporal lobe(16/84,19.05%),basal ganglia(2/84,2.38%), Infarct with hemorrhages in 1 case. Conclusion Combination with the history of venomous snake bitten, the acute cerebral infarction could be diagnosed by CT and MRI, which had great value in the clinical treatment planning for identifying the intracal hemorrhage.
【关键词】毒蛇咬伤;急性脑梗死;体层摄影术;X线计算机;磁共振成像
【中图分类号】R749.9;R841.42
【文献标识码】A
【DOI】10.3969/j.issn.1009-3257.2015.06.002
前言
据世界卫生组织报道在印度每年有超过200万人 被毒蛇咬伤,约35,000~50,000死于毒蛇咬伤。在我 国,每年约300,000人受毒蛇之害,每年死于毒蛇咬 伤大约在5,000人。毒蛇咬伤致急性脑梗死是较为罕 见的急症病变,其发生率很低,国内外都是以病例报 道形式报道,未见系统的相关报道。本病易与心血管 疾病导致的急性脑梗死相混淆,且因发病机制不同, 以至于治疗方法迥异,所以本病的诊断就相当重要。 现将本院2009.5~2014.10收治毒蛇咬伤致急性脑梗 死病例,结合文献报道进行回顾性影像学分析,以期 提高对毒蛇咬伤致急性脑梗死的诊断水平,减少误 诊。
罕少疾病杂志
第22卷, 第 6 期
2019年11月
相关文章