Neurology:心脏骤停后双侧颞侧新月形视野保留

2018-06-20 zyx整理 神经科病例撷英拾粹

48岁男性,主诉在经历了心脏骤停院外复苏后出现管状视力。最佳矫正视敏度为20/15(右眼和左眼)。瞳孔反应无殊。

48岁男性,主诉在经历了心脏骤停院外复苏后出现管状视力。最佳矫正视敏度为20/15(右眼和左眼)。瞳孔反应无殊。Goldmann视野检查可见双侧同向偏盲,中央不受累,并存在颞侧新月形保留(图1)。眼底镜检查双眼底正常。MRI提示双侧大脑后部分水岭梗死(图2)。这种位于视觉皮层对侧两极的2处视野区域不受累的特殊视野模式罕见,推测可能是由于血管冗余,保留了大多数前部和后部距状皮层所致。


(图1:心脏停搏后6个月的Goldmann动态视野检查可见双侧中央和颞侧新月形保留的同向偏盲)


(图2:A:DWI;B:ADC;C:T2WI;D:FLAIR;心脏骤停3天后获得的MRI可见双侧距状皮层信号异常)

原始出处:

Lindegger DJ, Helfenstein M, Job O,et al. Pless M.Mystery Case: Bilateral temporal crescent sparing after cardiac arrest. Neurology. 2018 May 29;90(22):1035-1036.

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    2018-10-11 yinhl1978
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    2018-06-21 大爰

    学习并分享!!

    0

  4. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Thu Jun 21 05:45:19 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325730, encodeId=9667325e30fa, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Thu Jun 21 05:45:17 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325708, encodeId=1cf6325e08e4, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Jun 21 00:06:50 CST 2018, time=2018-06-21, status=1, ipAttribution=)]
    2018-06-21 龙胆草

    学习谢谢分享

    0

  5. 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objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Jun 21 00:06:50 CST 2018, time=2018-06-21, status=1, ipAttribution=)]
    2018-06-21 12225669m29暂无昵称

    学习

    0

  6. 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objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Jun 21 00:06:50 CST 2018, time=2018-06-21, status=1, ipAttribution=)]
    2018-06-21 神功盖世

    0

  7. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Thu Jun 21 05:45:19 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325730, encodeId=9667325e30fa, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Thu Jun 21 05:45:17 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325708, encodeId=1cf6325e08e4, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Jun 21 00:06:50 CST 2018, time=2018-06-21, status=1, ipAttribution=)]
    2018-06-21 wzb521zf

    一起学习学习

    0

  8. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Thu Jun 21 05:45:19 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325730, encodeId=9667325e30fa, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Thu Jun 21 05:45:17 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325708, encodeId=1cf6325e08e4, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Jun 21 00:06:50 CST 2018, time=2018-06-21, status=1, ipAttribution=)]
    2018-06-21 哈哈869

    学了

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2000472, encodeId=34bf20004e2a1, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Thu Oct 11 03:56:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522408, encodeId=dda3152240803, content=<a href='/topic/show?id=46223e39897' target=_blank style='color:#2F92EE;'>#双侧#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37398, encryptionId=46223e39897, topicName=双侧)], attachment=null, authenticateStatus=null, createdAvatar=null, 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Thu Jun 21 05:45:19 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325730, encodeId=9667325e30fa, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Thu Jun 21 05:45:17 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325708, encodeId=1cf6325e08e4, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Jun 21 00:06:50 CST 2018, time=2018-06-21, status=1, ipAttribution=)]
    2018-06-21 哈哈869

    学了

    0

  10. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Thu Jun 21 05:45:19 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325730, encodeId=9667325e30fa, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Thu Jun 21 05:45:17 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325708, encodeId=1cf6325e08e4, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Jun 21 00:06:50 CST 2018, time=2018-06-21, status=1, ipAttribution=)]
    2018-06-21 飛歌

    学习了很有用不错

    0

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既往研究证明尽早应用肾上腺素可提高休克性初始心律性院外心脏骤停(OHCA)患者的存活率。但肾上腺素应用时间对非休克性初始心律患者的效应尚不明确。现有研究人员对肾上腺素应用时间和急救医疗服务(EMS)治疗的非休克性初始心律的OHCA成人和儿童患者的存活率的关联进行探究。研究人员对2011年6月4日-2015年6月30日复苏预后联网前瞻性鉴定的OHCAs进行二次分析。纳入EMS治疗的非休克性心律的OH

Neurology:小儿心脏骤停后神经结果评估工具研究

研究认为PRCA评分是小儿心脏骤停患者神经学结果描述强有力的方法,为神经功能损伤、领域特异性损伤以及神经行为结果指标之间的相关性研究提供工具

NEJM病例:是谁,夺去了这位年轻女性的心跳?

“铃铃铃”,急诊室的电话突然响起,电话另一头传来一位女性急促的声音:“医生,快来救救我的女儿,她现在倒在地上,已经没有心跳了”。

Crit Care Med:心脏骤停患者使用哪种血管活性药物能获得更好结局?

2018年5月,发表在《Crit Care Med》的一项由意大利、英国和瑞士科学家进行的网状Meta分析,考察了心肺复苏期间使用的血管活性药物方案对生存率和神经病学结局的影响。

Circulation:快速除颤(≤2min)和肾上腺素治疗(≤5min)可大大提高心脏骤停患者的长期存活率!

既往研究报道在医院内心脏骤停(IHCA)的患者,及时予以除颤和肾上腺素治疗可大大提高住院存活率。但这种存活率优势在出院后是否还持续存在尚不明确。研究人员通过检索国家IHCA医疗记录(2000年-2011年间、517家医院)共筛出36961位(年龄≥65岁)IHCA患者。由无脉搏性室性心动过速或室颤导致的IHCA患者,分为快速除颤(≤2min)和延迟除颤(>2min);由心脏骤停或无脉搏性电活动引起