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急性脑卒中救治规范与流程(英文）演示课件.ppt

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WenguiYu,MD,PhDDivisionofNeurologicalCriticalCareDepartmentsofNeurologicalSurgeryandNeurologyNeurocriticalCareofAcuteStroke1ThePrimaryDiagnosesInNeuro-ICUIntracerebralhemorrhage(ICH)Subarachnoidhemorrhage(SAH)Ischemicstroke/TIAsStatuspostcraniotomyfortumorresectionTraumaticbraininjury(SDH,EDH)Statuspostcoilembolization,angioplasty,-PAIntraarterialt-PAEndovasculartherapyAngioplasty/StentingMERCIRetrievalPenumbraClotRetrievalCoilembolizationofaneurysmSurgicaltreatmentHemicraniectomyforMCAstrokeAdvancesinStrokeManagementS/-monitoring1).hangesthatneedimmediateattentionMentalstatuschangeDecreasedlevelsofconsciousness:lethargy,:name,place,time,:expressiveorreceptiveaphasiaCranialnervepalsy:dilatedandfixedpupil(s)Newweakness/numbness42).Neuroimagingsa).CT Tofollowhematomaexpansion,cerebraledema,masseffect,herniation,,Deteriorationonneuroexam,).CTAContrastextravasationpredictshematomaexpansionCTdemonstratesaleftputaminalhematoma(A).AsmallfocusofenhancementisseenonCTA(B),consistentwithextravasationonpostcontrastCT(C).UnenhancedCTimage1dayafterpresentationrevealshematomaenlargementandIVH(D). -;38:1257 -;20;68(12):889--yomanunderwentimaging2hrsfollowingonsetofright-(A).CTA(B)andCECT(C),respectively,show2fociofactiveextravasation(arrows).Follow-T12hrslatershowsmarkedhematomagrowthwithhemorrhageinbothlateralventriclesandseverehydrocephalus(D).;30:2025-;29:520-,indicatingthepresenceofsal

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