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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Clinical Improvement Related to Thrombolysis of Third Ventricular Blood Clot in a Patient With Thalamic Hemorrhage
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Clinical Improvement Related to Thrombolysis of Third Ventricular Blood Clot in a Patient With Thalamic Hemorrhage

机译:用丘脑出血患者第三心室血栓溶栓相关的临床改善

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摘要

Intraventricular extension of hemorrhage after intraparenchymal hemorrhage is associated with significant morbidity and mortality. Clinical improvement is reported in a patient with thalamic hemorrhage with intraventricular extension after third and fourth ventricular blood clot resolution with instillation of urokinase intraventricularly. A 49-year-old man with hypertension collapsed while at work. A computed tomography (CT) scan of the head revealed a left thalamic hemorrhage with extension into the lateral, third, and fourth ventricles and associated hydrocephalus. A left frontal intraventricular catheter (IVC) was placed and intraventricular urokinase was administered at a dose of 25,000 U every 12 hours. The CT scan revealed resolution of the lateral ventricular dilatation and blood clot but no decrease in third or fourth ventricular hemorrhage. No clinical improvement was noted. The IVC was reinserted on the right side with the catheter tip placed through the foramen of Monroe into the third ventricle. Twelve hours after receiving the first dose of urokinase through the new catheter, the patient's condition improved. The CT scan showed a reduction in the volume of blood of the third and fourth ventricles. This case report shows that treatment of hydrocephalus with an IVC was not sufficient to provide a therapeutic effect. Substantial clinical improvement occurred only after the blood clot was cleared from the third and fourth ventricles.
机译:心房出血后出血的脑内延伸与发病率和死亡率有关。患有患有血管内延伸的患者在第三和第四节室血凝凝块分辨率下,患有临床改善,静脉内血液凝块分辨率滴注尿激酶。一名49岁的人在工作时倒塌了高血压。头部的计算机断层扫描(CT)扫描显示左丘脑出血,延伸到侧,第三和第四脑室和相关的脑积水。左前腔内导管(IVC)置于置入腔内尿激酶,每12小时以25,000 000次施用。 CT扫描显示出侧心室扩张和血凝块的分辨率,但第三或第四心室出血没有减少。没有注意到临床改进。 IVC在右侧重新插入,导管尖端穿过Monroe的孔子进入第三脑室。通过新导管接受第一剂尿激酶后12小时,患者的病情改善了。 CT扫描显示第三和第四脑室的血量的减少。本病例报告显示,脑积水与IVC的治疗不足以提供治疗效果。仅在从第三和第四脑室清除血凝块后发生大量临床改善。

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