CT检查误诊为脑内肿瘤的脑梗死五例临床分析

Clinical Analysis of Misdiagnosis of Cerebral Infarction in Brain Tumors: Report of Five Cases

目的探讨临床表现类似脑内肿瘤的脑梗死误诊原因。方法回顾性分析我院神经内科收治的CT检查误诊为脑内肿瘤的5例脑梗死患者临床资料。结果本组占我院同期收治脑梗死患者的4.46%。5例分别因头痛、呕吐、头昏、语言不清就诊,均无偏身感觉运动障碍、意识障碍等脑梗死典型表现,初诊根据临床表现及头颅CT检查结果误诊为脑内肿瘤,误诊时间3 h^10 d。5例入我院神经内科后经MRI检查确诊为脑梗死,其中右脑梗死4例、左脑梗死1例。确诊后,经抗血小板聚集、他汀类药物及控制血压等治疗,病情好转出院。出院后随访3个月~1年,5例恢复良好,未再复发。结论临床表现不典型的脑梗死患者易与脑内肿瘤混淆,头颅MRI检查有助于二者鉴别。

Objective To investigate the cause of cerebral infarction misdiagnosed as brain tumors.Methods Retrospective analysis of 5 cases of clinical data of CT in our department of Neurology,which was misdiagnosed as brain tumor.Results This group accounts for 4.46%of the cerebral infarction in our hospital during the same period.5 cases were diagnosed as headache,vomiting,dizziness and language confusion,the initial diagnosis was misdiagnosed as brain tumor according to clinical features and the results of head CT examination.Misdiagnosis time was 3 h-10 d.5 cases were diagnosed as cerebral infarction by MRI examination,including 4 cases of right cerebral infarction and 1 cases of left cerebral infarction.After diagnosis,the patient was discharged from hospital after receiving corresponding treatment,such as antiplatelet aggregation,statins and blood pressure control,and were followed up for 3 months to 1 years after discharge.5 patients recovered well without recurrence.Conclusion Cerebral infarction patients with atypical clinical manifestations are easily confused with intracerebral tumors.Cranial MRI examination is helpful for the identification.