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ER() CASE STUDY
08802020
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CASE : OO : Cerebral Infarction() : (2000), (2001)
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1. (Cerebral infarction) () , () . , . . , , . X- CT .
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1. , CT, ECG . 50% . ECG .CBC, , (, ), . , .
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1. . CT . 6 . CT .
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1. . , . . . .
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1. nitroprusside, labetolol, captoprilol nitroprusside .
nifedipine . . . .( : 20mg/kg, : 2.5mg/min)
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1. - TIA . - TIA( ) TIA . 6 70~99% .
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1. (2) - . - 3~4 .(3) - .- .-(, , rt-PA) .
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1. - . 3 . . - 6 , 12~24 .- . .
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1. (4) - - . - TIA - .(5) - .
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1. (6) - - - - (, )- - ( )- - ( )
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2. 1.
Trauma Cerebral Infarction .Rt.side weakness . : ( ) :
2010.11.08
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2. 2. : Cerebral Infarction - : Rt. Side weakness Rt : 2, Lt :
5
2255
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2. : Cerebral Infarction- : Rt. Side weakness Rt : 2, Lt : 5
CT 1cm , (mass effect), .
WBC 11.60() : , , HCT 56% () : . 2255
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2. 3)
Processing data2010.11.9 15:23 Trauma cerebral infarction 15:25
Patient monitor , V/S - NIBP : 171/69mmHg, HR : 100/min, RR :
18/min, SpO2 : 100%15:34 EKG checked15:35 EM Doctor diffusion , CMR
, () 16:00 V/S 140/80-80-18 checked16:35 V/S 130/80-78-18 checked,
observation now
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2.
Processing data2010.11.9 17:25 send to MRI room, CT room17:48
Notify to NEV Doctor17:55 X-ray checked18:00 V/S 130/80-80-18
checked18:39 NEX Doctor , . 18:57 NEV Doctor REFUSE 19:05 IV line
removed, V/S 140/80-82-18 checked, , , transfer
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2. 4)
WBC11.33()4~10.8() , HB14.4 ()14g/dL() HCT56 ()42~52%()
.MCV99.9()80~94fL() , ,
.MCH35.0()27~33pgMCHC35.033~37g/dLHDW2.732.2~3.2%PLT420 ()130~400()
, , , MPV331130~400
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2.
ColorStrawAmbar-yellow TurbidityClearClear
S.G.1.0201.010~1.025PH8.04.6~8.0Protein-10~100mg/24hrGlucose-NegativeKetone
-NegativeBlood-NegativeUrobilinogen+-0.1~1.0u/dl , bilirubin
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2.
BUN118~20mg/dlCreatinine0.770.6~1.2mg/dlProtein,
total7.96.5~8.0g/dlAlkaline
Phosphatase9240~120IV/LAST(GDT)43()10~35IV/L() , , , , ,
ALT(GPT)44()8~38IV/LNa137137~145mmol/LCl10.699~109mmol/LCO230.925~37mmol/LAnion
Gap4()10~21mmol/L
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2. Chest X-ray . CT 1cm , (mass effect), .
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3. : : 17 5 Volume 17, Number 5, Ocotober, 2006 : case (Cerebral
Infarction) .
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3. , , National Institutes of Health Stroke Scale(NIHSS), , , ,
, , , , , . .
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3. 2004 3 1 ~5 31, 172 24 74 . , , , , , ,
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3. NIHSS 0~5, 6~10, 11~!5, 16~20, 21 5 TOAST , , , 5
NIHSS(NIHSS-DC), modified Rankin scale(mRs),Barthel index(BI)
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3. 173, 11, 9, 24 70, 1 74 64,
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3. , , NIHSS( ) . ( , )
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3. : ,
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3. Stroke NIHSS . . .
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3. : 7 , , 3 .
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4.
GCS E4, V2, M4 .(V2 : )
Rt , 2 ( )
, ,
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4.
PLT : 420() , , ,
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5. # 1
- , ( )-
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5. # 2
Rt , 2 ( )
, ,
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5.
# 3
PLT : 420() , , ,
IV
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6. # 1 : : , , .# 2 : : .# 3 : : .
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7.
. , , , , . . .
. : . .
. . .
# 1 :
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7.
. ROM , .
. , .
2 30
# 2 :
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7.
# 3 :
. . . .
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8. # 1 : : . .
, .
.
# 2 :
# 3 :
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9. (2009) . . (2000) . . (2005). .
http://health.search.naver.com/search.naver?where=health_detail&sm=tab_txc&ie=utf8&query=%ED%97%88%ED%98%88%EC%84%B1%20%EB%87%8C%EC%A1%B8%EC%A4%91
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