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卒中可以是中枢神经系统新生物的首发表现。有人曾特别描述过垂体卒中综合征。曾提示,在新生物存在的情况下,抗凝药物的应用可以增加病损合并出血的危险。本文报告一例接受抗凝治疗的病人,继发出血至松果体囊肿内,引起松果体区综合病症。患者男性56岁,入院前96小时曾有严重的枕部头痛和恶心的急性发作。在症状开始的六小时之内,轻度昏睡并有定向紊乱合并步态不稳。六个月来因多发性肺梗塞使用双香豆素抗凝治疗。检查血压130/90mmHg,定向不良,有严重的远近记忆力丧失。明显向上凝视受限合并右瞳孔反应降低。侧视时出现眼震,右视较明显。全身反射亢进,右侧尤著。左侧伸性足蹠反射。无颈强直。腰穿压力正常,无细胞,蛋白154mg%。颅片,脑超声波和脑扫描正常。
Stroke can be a first manifestation of CNS neoplasms. Pituitary syndrome has been described in particular. It has been suggested that the use of anticoagulants in the presence of new organisms may increase the risk of morbidity and bleeding. This article reports a case of anticoagulant therapy in patients with secondary bleeding to the pineal cyst, causing pineal complex disease. The patient, 56 years old, had severe occipital headache and nausea and an acute episode 96 hours prior to admission. Within six hours of onset of symptoms, mild lethargy and disorientation combined with unstable gait. Use of dicoumarol anticoagulation for multiple pulmonary infarcts in six months. Check blood pressure 130 / 90mmHg, poor orientation, there is a serious loss of near and far memory. Obvious upward gaze restricted right pupil response reduced. Ocular nystagmus when looking side, the right visual more obvious. Hyperreflexia, especially on the right. Left extensor plantar reflex. No neck stiffness. Waist wear pressure normal, cell-free, protein 154mg%. Cranium, brain ultrasound and brain scan normal.