课件出血性卒中

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1、HemorrhagicStrokeCaseDiscussMay9,2001welcomePart1---casereportPart2---caseanalysisPart3---relatedinfoPart4---anatomyreviewPartoneCasereportMedicalrecordMrs.Zhou,married,female,age37,nurse,wasadmittedonApril13,2001withachiefcomplaintofsuddenright-limbweaknessa

2、ndslurredspeechfor13days.HistoryofPresentIllness-1Mrs.Zhouhadright-limbweaknessabruptlyonherwayhome13daysprior.Thenshewasunabletostandupandholdsomethingbyrighthand,withdisturbanceofspeechatsamemoment.Moreover,shestillfeltmilddizzinessconcurrently.Shedeniedhea

3、dache,nauseanorvomiting.Limbconvulsiveseizureandlossofconsciousnesswerenotfoundduringthecourse.Therewasnourinaryorfecalincontinenceaswell.ShewassenttoHanDanHospitalbyhermatesimmediately.TheCTscanshowedintracerebralhemorrhageandherbloodpressureatthattimeroseto

4、165/90mmHg.HistoryofPresentIllness-2Shehadpoorappetiteandfatiguesinceshewassick.Onlyliquiddietwastakenafterillness.Therewasnodysipsia.Bowelmovementandurinationwerenormal.HistoryofPresentIllness-3Onphysicalexamination,shewasalertbutaphasia;themusclepowerofrigh

5、t-limbwas0andBabinski’ssignonbothsideswaspositive.Therewasalsonumbness(hemihypoesthesia)onright-side.Thenshewasputondehydratingagent,hemostatic,multiplevitaminsandsoon.Thepatientwasonstateofover-drowsyforthreedaysuntilsherevived.Thenthedisturbanceofspeechhad

6、somewhatimprovedbutstillslurred.Andfurthermore,paralysisofright-limbdidn’timproveapparently.ShewastransferredtoourhospitalonApril13,2001toreceivefurtherdiagnosisandtreatment.PastmedicalhistoryOccasionallyhypertensionafterexertion,usually135/90-95mmHg.Herblood

7、pressureroseto165/90mmHgforseveraltimesaftersick.Denythehistoryofcardiopathy,diabetesmellitusorstroke.Sufferedfrommiliarytuberculosisoflungattheageof15.Allergichistoryfordrugsincludecephalexia,ciproflexinandagluminethamsylate.Personalhistory/FamilyhistoryDeny

8、smokinganddrinking.Mildcharater.Marriedwithachild.Hasafamilyhistoryofstroke(motherandfather).N.Sphysicalexam-1Mentalstate:Alert,oriented;intactintelligence.Speech:alalia.Cranialnerves:Ⅱ(o