脑卒中|一例苏醒延迟引起的思考( 四 ) 机械|用药指南

●颅内压升高–颅内压急性升高可能发生于以下情况时：颅内血肿手术或肿瘤手术后、脑水肿(例如，严重创伤性脑损伤、大面积脑梗死、急性缺氧缺血性脑病)、脑室腹腔分流(ventriculoperitoneal VP)障碍或脑静脉流出道梗阻(例如，静脉窦血栓形成、颈静脉受压和颈部手术) 。
●既往神经功能障碍–具有脑卒中或其他原因所致神经系统损伤既往史的患者，镇静或全身麻醉后可能发生短暂的局灶性神经功能障碍；这种现象称为差异性觉醒(differential awakening) 。这种异常通常会在30分钟至数小时后改善，但需要多学科评估。
●高灌注综合征–脑高灌注综合征是颈动脉内膜切除术的罕见后遗症。
●空气栓塞或脂肪栓塞综合征–手术后不久，患者可能因动脉空气栓塞或脂肪栓塞综合征而出现局灶性神经功能障碍或神志改变。
作者：张子银广州中医药大学第一附属医院
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