简介:摘要目的探讨大面积大脑半球梗死患者的少见病因、临床特点及结局.方法对13例少见病因所致的大面积大脑半球梗死患者的病因、临床特点及结局进行分析.结果13例患者中有6例不存在任何常见脑血管病危险因素,余7例患者中,3例为自发性颈动脉夹层,1例为moyamoya病,1例为升主动脉夹层动脉瘤,1例为真性红细胞增多症,1例为脑出血血肿清除术后继发同侧半球大面积脑梗死.11例(84.6%)患者在住院期间发生了神经系统及全身并发症,4例患者行去骨瓣减压术.至3月随访期末,6例患者死亡,存活者中仅1例生活基本自理,余6例均遗留中至重度残疾.结论大面积大脑半球梗死病因搜索过程中应重视病史询问.少见病因大面积大脑半球梗死患者虽更年轻,有更少的合并症,整个病情发展仍极其凶险,预后极差.关键词大面积大脑半球梗死;病因;预后Unusualcausesof1argehemisphereinfarctionacaseseriesof13patientsAbstractobjectiveToexplorethepathogenesis,characteristicsandoutcomeoflargehemisphereinfarctionofunusualcauses.MethodsThirteencasesoflargehemisphereinfarctionofunusualcauseswereprospectivelyregisteredandanalyzedtheirstrokepathogenesis,clinicalcharacteristicsandclinicaloutcome.ReGsultsAmongthe13patients,10wereundertheageof60yearsold.Mostofthepatientswereinacriticalconditiononadmission.12sufferedconsciousdisturbGanceonadmissionand5withcoma.Thepatientssufferedstroke-relatedneurologicalormedicalcomplicationsduringhospitalizationand4underwentdecompresGsivesurgery.InclusionAdetailedpatienthistoryisofgreatimportanceinthepathogenesisoflargehemisphereinfarctionespeciallyforyoungerpatients.AlGthoughpatientswithlargehemisphereinfarctionofunusualcausesareyoungerandwithlesscomorbidities,theirexpectedclinicalcourseareseriousandmostlyhaveaKpeoyorwoorudtscome.largehemisphereinfarction,pathogenesis,outcome中图分类号R733文献标识码B文章编号1008-6315(2015)12-0905-01