自由基与蛛网膜下腔出血后脑血管痉挛的关系及防治策略

脑血管痉挛是蛛网膜下腔出血后的严重并发症之一,可引起脑组织严重缺血或迟发性缺血性脑损伤,甚至导致脑梗死,但其病理机制仍未完全清楚,而越来越多的研究表明自由基在脑血管痉挛病理变化过程中发挥着重要作用。通过对自由基与脑血管痉挛之间关系的科学分析,探讨蛛网膜下腔出血后与自由基相关的脑血管痉挛的防治策略。     

动脉瘤性蛛网膜下腔出血的临床诊疗决策

探讨动脉瘤性蛛网膜下腔出血的临床诊疗决策.运用循证医学时动脉瘤性蛛网膜下腔出血早期诊断,及时、合理、有效地选择个性化的治疗方案,降低动脉瘤性蛛网膜下腔出血的病残率和死亡率.     

动脉瘤性蛛网膜下腔出血的临床诊疗决策

探讨动脉瘤性蛛网膜下腔出血的临床诊疗决策。运用循证医学对动脉瘤性蛛网膜下腔出血早期诊断,及时、合理、有效地选择个性化的治疗方案,降低动脉瘤性蛛网膜下腔出血的病残率和死亡率。     

从蛛网膜下腔出血误诊谈临床思维

从蛛网膜下腔出血误诊谈临床思维大连市第五人民医院内科（１１６０２１）徐海波蛛网膜下腔出血如出现典型的临床表现,像突然发生的剧烈持久的头痛、呕吐及颈项强直等,易引起医务人员的注意,容易明确加以诊断。但临床上经常出现的是不典型的蛛网膜下腔出血,其临床表现...     

高血糖对蛛网膜下腔出血患者预后的影响

为了探讨蛛网膜下腔出血（SAH）患者血糖值与胰岛素治疗反应及预后的关系。我们回顾性分析65例SAH患者的临床资料,分为血糖明显升高组（血糖值〉11．0mmol／L）、血糖轻度升高组（血糖7．0mmol／L-11．0mmol／L）和血糖正常组（血糖值〈7．0mmol／L）,比较各组在胰岛素治疗反应、病情严重程度及预后方面的差异。结果显示大部分患者血糖都有不同程度的升高,病情越重,出现应激性高血糖的几率越高,强化胰岛素治疗效果越不理想;且血糖值越高,预后越差。有研究表明血糖增高是蛛网膜下腔出血脑组织神经功能受损后应激反应的结果,血糖增高可作为病情加重及预后的预测因子之一。     

浅析神经外科中的诊疗思路和思维方式

应该注重培训年轻医生在临床中学会应用哲学思想和思维方式,真正认识事物的本质.这对于诊断、治疗、科研、创新有事半功倍的作用,可避免片面性、盲目性,减少医源性偏差与失误,提高治愈率和生活质量.一般通过三种思维方式即理论、工程及评价思维思考疾病,如蛛网膜下腔出血的病因、临床特点、检查方法、诊疗思路、预后和转归,最终达到预期的疗效.     

介入治疗鞍内动脉瘤并蛛网膜下腔出血1例临床分析

探讨鞍内动脉瘤出血的临床表现、诊断与治疗策略。分析1例鞍内动脉瘤出血患者临床资料并复习文献。头颅CT检查确定为蛛网膜下腔出血,急诊行脑血管造影确诊为动脉瘤,成功介入手术治疗。破裂的鞍内动脉瘤诊断较为容易,未破裂动脉瘤尤其是巨大鞍内动脉瘤诊断困难,易与鞍内肿瘤混淆,对可疑者应及时行多层螺旋CT血管成像(CTA)、磁共振血管造影(MRA),确诊依靠数字减影血管造影(DSA)检查,确诊后选择恰当治疗方案。     

外伤性脑梗死的病因分析与防治策略

外伤性脑梗死是颅脑外伤患者比较常见且严重的一种并发症.其病因主要是脑血管壁损伤、血管受机械牵拉挤压、脑血管痉挛及低灌注、氧自由基及其他血管活性物质的改变.随着影像技术的发展进步,外伤性脑梗死的早期诊断已基本能做到,了解其主要发病机制以后,针对性地给予扩容,保证脑灌注压.通过提早预防、早期手术和内科药物、物理治疗方法,改善预后.     

浅析神经外科中的诊疗思路和思维方式

应该注重培训年轻医生在临床中学会应用哲学思想和思维方式,真正认识事物的本质。这对于诊断、治疗、科研、创新有事半功倍的作用,可避免片面性、盲目性,减少医源性偏差与失误,提高治愈率和生活质量。一般通过三种思维方式即理论、工程及评价思维思考疾病,如蛛网膜下腔出血的病因、临床特点、检查方法、诊疗思路、预后和转归,最终达到预期的疗效。     

自由基在神经外科手术时脑保护中的意义

神经外科手术中脑内自由基(主要是氧自由基)产生增加,脂质过氧化反应增强,造成细胞结构和功能上的继发性损伤.自由基在继发性损伤中的具体机制尚未完全清楚,可能与缺血级联反应、缺血再灌注和细胞凋亡有关.术中采取措施清除自由基以及减少自由基的产生将有助于保护损伤的脑组织.     

脑功能一侧化加工中的元控制研究

1　引言　　有关大脑功能一侧化问题 ,本世纪 60年代前后的研究显示左右脑功能在言语和非言语方面有差异 ,70年代中期发现左右脑对外部信息的加工有分析与综合方式的差异 ,80年代中后期又发现左右脑对信息的表征特性也有一侧化现象 ,即左脑适合处理高频视觉空间刺激 ,而右脑适合处理低频视觉空间刺激。显然 ,以上研究采用的是二分法原则在不同的范畴内查寻左右脑功能活动以及加工特性的差异。值得重视的是 ,近期的不少研究提示不应过高估计这种功能差异。即使它们存在 ,对于正常人而言它也只能在左右脑正常功能关系状态下起作用。因此 ,有关…     

Cerebral lateralization and reading dysfunction

The laterality preference patterns and types of oral reading errors were examined for 90 seventh-grade males. Specifically, scores on a self-report measure of lateral preference for 30 readers with adequate decoding skills but low comprehension and 30 readers who lacked decoding skills were compared with each other and with 30 good readers. As predicted, poor readers with grade appropriate word recognition scores were found to be generally more confused in their lateral preference than were good readers or poor readers who lacked decoding skills. Results of oral reading errors confirmed a visual integration problem for the more bilateral reader. Poor comprehenders with word recognition skills also reported significantly greater mixed lateral patterns for their fathers than did other readers. The results were interpreted as supporting the initial argument that difference-poor readers fail to comprehend because of problems in organizing visual input, which seems intimately tied to a bilateralization of functions.     

Cerebral death

Theoretical Medicine and Bioethics - The notion of cerebral death is examined in relation to those of cardiopulmonary and whole-brain death. It is argued that rather than being a new concept of...     

Cerebral hemispheres and selective attention

The present paper is intended to discuss critically the integration model of the functional interhemispheric relation that has become dominant in neuropsychology with the development, in the last two decades, of split-brain studies.While the split-brain research has undoubtedly produced new experimental methodologies, the current theorizing in this area has been contrastingly conservative. The present paper examines some of its basic assumptions, in particular that the corpus callosum is an association pathway devoted to interhemispheric transmission of information, and that the disconnected cerebral hemispheres function in a parallel way. It is shown that these assumptions have only low consistency both with split-brain behavior and with the normal organization of the fore-brain connectivity.In the early seventies, theoretical novelty has emerged from another research field with Kinsbourne's interpretation of laterality effects in normal man. His concept of asymmetrical hemispheric arousal is shown to be supported, with some reservations, by evidence in this field. But this dynamical concept has a more general value and there are signs that current ideas about the functional relation between the cerebral hemispheres are presently deeply transformed.     

大脑两半球功能不对称性与儿童学业成绩

本研究调查了 3 1 8名小学一至三年级学生大脑两半球优势情况 ,然后对不同优势半球学生的语文和数学成绩进行了比较。结果发现优势半球为右半球的学生人数较少 ,只有 3 .8% ,明显少于优势半球为左半球的学生 (χ2 =2 3 9.83 0 ,p<0 .0 0 1 )。对不同优势半球学生的语文和数学成绩的比较 ,未发现两者有显著差异 (语文 :F=1 .1 3 0 ,p>0 .0 5 ;数学 :F=0 .5 75 ,p>0 .0 5 )。