摘要
目的 探讨自发性颅内出血后急性癫痫发作与进展性脑水肿、中线移位和临床神经功能恶化的关系。方法 对72例脑卒中患者 (缺血性卒中 30例 ,脑出血 4 2例 )入院后进行脑电图监测 ,于出血后 2 4、4 8、72h进行头颅CT扫描 ,确定癫痫发生率、发作的时间及与出血量和中线移位的关系 ,并于出院时用Glasgow预后评分对患者进行评估。结果 共有 17例患者入院 72h内脑电图有癫痫波 ,脑出血 13例 (33% ) ,脑梗死 4例 (13% ) ,脑出血患者癫痫发生率明显高于后者 (P <0 0 5 ) ;以皮层出血发生癫痫最常见 ,其次是皮层下出血 ;发作形式以局灶性发作继发全身发作居多 ;癫痫发作患者与NIH卒中评分低和中线移位明显相关 (P <0 0 5 )。结论 脑出血常伴癫痫发作 ,与出血后脑水肿和中线移位增加有关 ,并伴有明显预后不良。
Objective To explore the relationship between acute seizures occur frequently after intracerebral hemorrhage(ICH)and progressive brain edema,middle shift and clinical neurologic deterioration.Methods A total of 72 patients with ischemic stroke(n=30)and intracerebral hemorrhage(n=42)underwent continuous electroencephalogram(EEG) monitoring after admission,and the patients were given serial computed tomography(CT) scan at 24,48 and 72 h after hemorrhage to determine the relationship between seizures incidence,timing,hemorrhage volume and middle shift.Outcome at the time of discharge was assessed with Glasgow outcome scale score.Results Electrographic seizures occurred in 13 of 42(33%)patients with ICH and 4 of 30(13%)patients with ischemic stroke during the 72 hours after admission.The seizures incidence in ICH were significantly higher than the latter(P<0.05).Seizures were more common in lobar hemorrhage,the second was subcortical hemorrhage.Seizures were most often focal on secondary generalization,and posthemorrhage seizures were associated with low NIH stroke scale and with an increase in middle shift(P<0.05).Conclusion Seizures occur commonly after ICH.It associated with edema and an increase in middle shift,and often accompany with outcome worsening.
出处
《中国急救医学》
CAS
CSCD
北大核心
2005年第1期20-22,共3页
Chinese Journal of Critical Care Medicine
关键词
颅内出血
癫痫发作
脑电图
预后
Intracerebral hemorrhage
Seizures
Electroencephalogram(EEG)
Outcome
