資源描述:
《課件出血性卒中》由會員上傳分享,免費在線閱讀,更多相關內容在教育資源-天天文庫。
1、HemorrhagicStrokeCaseDiscussMay9,2001welcomePart1---casereportPart2---caseanalysisPart3---relatedinfoPart4---anatomyreviewPartoneCasereportMedicalrecordMrs.Zhou,married,female,age37,nurse,wasadmittedonApril13,2001withachiefcomplaintofsuddenright-limbweaknessa
2、ndslurredspeechfor13days.HistoryofPresentIllness-1Mrs.Zhouhadright-limbweaknessabruptlyonherwayhome13daysprior.Thenshewasunabletostandupandholdsomethingbyrighthand,withdisturbanceofspeechatsamemoment.Moreover,shestillfeltmilddizzinessconcurrently.Shedeniedhea
3、dache,nauseanorvomiting.Limbconvulsiveseizureandlossofconsciousnesswerenotfoundduringthecourse.Therewasnourinaryorfecalincontinenceaswell.ShewassenttoHanDanHospitalbyhermatesimmediately.TheCTscanshowedintracerebralhemorrhageandherbloodpressureatthattimeroseto
4、165/90mmHg.HistoryofPresentIllness-2Shehadpoorappetiteandfatiguesinceshewassick.Onlyliquiddietwastakenafterillness.Therewasnodysipsia.Bowelmovementandurinationwerenormal.HistoryofPresentIllness-3Onphysicalexamination,shewasalertbutaphasia;themusclepowerofrigh
5、t-limbwas0?andBabinski’ssignonbothsideswaspositive.Therewasalsonumbness(hemihypoesthesia)onright-side.Thenshewasputondehydratingagent,hemostatic,multiplevitaminsandsoon.Thepatientwasonstateofover-drowsyforthreedaysuntilsherevived.Thenthedisturbanceofspeechhad
6、somewhatimprovedbutstillslurred.Andfurthermore,paralysisofright-limbdidn’timproveapparently.ShewastransferredtoourhospitalonApril13,2001toreceivefurtherdiagnosisandtreatment.PastmedicalhistoryOccasionallyhypertensionafterexertion,usually135/90-95mmHg.Herblood
7、pressureroseto165/90mmHgforseveraltimesaftersick.Denythehistoryofcardiopathy,diabetesmellitusorstroke.Sufferedfrommiliarytuberculosisoflungattheageof15.Allergichistoryfordrugsincludecephalexia,ciproflexinandagluminethamsylate.Personalhistory/FamilyhistoryDeny
8、smokinganddrinking.Mildcharater.Marriedwithachild.Hasafamilyhistoryofstroke(motherandfather).N.Sphysicalexam-1Mentalstate:Alert,oriented;intactintelligence.Speech:alalia.Cranialnerves:Ⅱ(o