重型高血压性脑出血病理与临床关系的探讨（附20例尸检资料）

Clinicopathologic Study of severe hypertensive cerebral hemorrhage: autopsy in 20 patients

对２０例重型高血压性脑出血进行了病理改变与其临床关系的探讨。结果表明：重型高血压性脑出血以基底节外侧混合型出血多见，出血量大，常继发脑室出血、蛛网膜下腔出血及脑干出血。其病情的严重程度与高血压病史时间的长短无关，但本组患者发病前后血压均很高。主要体征为意识障碍出现的早、瞳孔不等大或双瞳孔缩小、去脑强直、完全性肢瘫及双侧病理反射阳性。本资料提示脑出血的严重程度并非取决于出血部位，主要取决于出血量的大小。坚持长期有效地治疗高血压仍是预防重型高血压性脑出血的重要措施。

The relationship between the pathologic changesand clinical manifestations in 20 patients with hyperten-sive cerebral hemorrhage was studied.Severe hyperten-sive cerebral hemorrhage was mostly of the mixed type,occurring massively and commonly in the lateral part ofthe basal ganglion,accompanied frequently by intraven-tricular, subarach noid and brain stem hemorrhage. Theseverity of the disease was not related to the length oftime of hypertension. However,notable hypertension wasseen in all patients before and after the onset of the dis-ease. The main signs of the patients included the earlyappearance of the disturbance of consciousness,irregularpupils or bilateral myosis, decerebrate rigidity,completelimb paralysis and bilateral positive Babinski sign. It issuggested that the severity of cerebral hemorrhage de-pends largely on the amount of bleeding rather than thesite of bleeding,Long term effective treatment of hyper-tension is still an important measure for the prevention ofsevere hypertensive cerebral hemorrhage.