<正>1案情摘要被鉴定人男,50岁,因交通事故致颅脑损伤,于2005年8月23日急诊收住某省某县人民医院外科。2005年8月30日在全身麻醉下施行开颅血肿清除及去骨瓣减压术,术后当天死亡。家属认为,因医方延误治疗而导致患者死亡,并诉至某县人民法院。医方辩称:患者伤情严重,由于家属拒绝医方制定的早期手术方案,坚持保守治疗,
<正>脑脓肿系化脓性病原体侵入脑内形成的单个或多个脓腔,主要表现为占位性病变。部分患者在病程中可无发热,整个过程与脑瘤相似。现将1例脑脓肿死亡与医疗行为之间是否存在一定因果关系的案例点评如下。
Objective To explore the clinical features and treatment of giant intracranial aneurysm with narrow neck.Methods We retrospectively analyzed the diagnosis and treatment of 2 cases of giant intracranial aneurysms of narrow neck.Results The two giant intracranial aneurysms with narrow neck were easily resected without any sequela.Conclusion Giant intracranial aneurysm with narrow neck is very rare.It is difficult to diagnoze clinical- ly;it is necessary to use such means as CT,MR.or MRA as well as DSA to confirm it comprehensively.In order to achieve the aim to be cured,surgical resection is the only effective method.
Objective To evaluate the risk factors for gastrointestinal bleeding after severe head trauma.Method 153 cases of severe craniocerebral injury were retrospectively analysed.Results Gastrointestinal bleeding was found in 49 cases(30%).This analysis indicated 4 significant risk factors for predicting the development of gastrointestinal bleeding:1.GCS,2.decereberate rigidity,3.high fever,4.hyperglycemia.Conclusion We must be constantly on our guard against gastrointestinal bleeding among ICU patients with severe craniocereral injury,especially among those with risk factors. [
The present study was designed to prospectively investigated the prostaglandin (PG) levels and extent of peritumoral edema in 30 cases of glioma by using methods of radioimmunoassay and imaging. Both TXB2 and 6-keto-PGF10 levels in all glioma groups went up over that in the control group. TXB2 level and ratio of TXB2/6-keto-PGF10 were markedly increased with the extent of tumor malignancy. Water concentration in anaplastic astrocytoma and glioblastoma were significantly elevated. Difference in TXB2 level and TXB2/6-keto-PGF10 ratio among three edema grades were statistically significant. TXB2 level and ratio of TXB2/6-keto-PGF10 were closely correlated with water concentration (r1 = 0. 53, r2 = 0. 72,P <0. 01). Our findings suggested that the metabolism of PG in glioma were in the state of disorder, and that the imbalance between PGI2 and TXA2 may be one of factors which affect the formation of peritumoral edema.
