少见毒蛇咬伤致急性脑梗死的CT和MRI表现

Acute Cerebral Infarction by Venomous Snake Bite in CT and MRI

目的探讨毒蛇咬伤致急性脑梗死的CT和MRI表现特征。方法对7例毒蛇咬伤致急性脑梗死的影像学表现结合文献进行回顾性分析。结果 7例患者,2例五步蛇咬伤,4例蝰蛇咬伤,1例不明毒蛇咬伤。大脑一叶或多叶脑组织内多发散在分布的斑点状、斑片状、片状急性脑梗死。7例共21个脑叶84个急性脑梗死病灶,其中顶叶7个26个病灶(26/84,30.95%)、额叶6个19个病灶(19/84,22.62%)、枕叶4个21个病灶(21/84,25%)、颞叶3个16个病灶(16/84,19.05%)、基底节1个2个病灶(2/84,2.38%),1例合并脑内出血。结论结合毒蛇咬伤史,CT和MRI检查对毒蛇咬伤致急性脑梗死可明确诊断,并明确有无出血,对临床治疗方案提供有价值的信息。

Objective To determine the CT and MRI findings of acute cerebral infarction by venomous snake bitten. Methods The imaging findings of 7 patients with acute cerebral infarction by venomous snake bitten were analyzed retrospectively with literatures review. Results 2 case was bitten by Pit viper. 4cases were bitten by Russell＇s viper and 1 case was unknown viper. One leaf or multiple leaves cerebrum occurred frequently. Acute obstruct with multiple mottling, patchy, or schistose. 84 acute cerebral infarction in 21 leaves cerebrum of 7 cases, parietal lobe（26/84,30.95%）,frontal lobe（19/84,22.62%）,occipital lobe（21/84,25%）,temporal lobe（16/84,19.05%）,basal ganglia（2/84,2.38%）, Infarct with hemorrhages in 1 case. Conclusion Combination with the history of venomous snake bitten, the acute cerebral infarction could be diagnosed by CT and MRI, which had great value in the clinical treatment planning for identifying the intracal hemorrhage.