Clinical Analysis On9Cases Of Central Nervous System Lesions Caused By Heat Stroke

BACKGROUND AND OBJECTIVESevere heatstroke is the most serious type, including heatstroke, heat cramps, and heat exhaustion. the mortality rate is as high as:10%～50%.Its main characteristic is core temperature from40℃up to47℃.Generally can be divided into two categories: the CHS and EHS.CHS is caused by exposure to high temperature environment, develops in the young, the old, the low immunity and people with underlying conditions. And because EHS is in high temperature and high humidity environment, engaging in the high strength fitness in healthy young people, athletes, military personnel, etc. Due to the high temperature, high humidity and strong sun environment, a lot of heat outside to the body, and the increased metabolic heat production, two kinds of physiological defense on the heat stress(regulate the circulation of the blood and sweat regulates) can’t work, the center temperature rise, and develop to heatstroke. Not only the temperature regulation system function dysfunction, often accompanied by the Circulatory system, Humoral regulation system, CNS, Digestive system damage, even developed to acute organ failure. The main precursor symptoms are headache, dizziness, severe thirst, nausea, vomiting, etc. Without interference the sudden stop sweating, temperature rise sharply followed, may be accompanied by shallow breathing, restless, confusion,limbs twitch、and even coma. Main physical sign:miosis, patellar tendon reflex and Pupilary light reflex reduced or disappeared, the pulse is weak and irregular, appear even irregular breathing, the symbol of which is very dangerous.Protein、red and white blood cells in the urine and urine chlorine ion、sodium ion reducing are important biochemical indexes. This paper summarizes the clinical characteristics,imaging manifestations, and prognosis of central nervous system lesions caused by heat stroke.METHODSA retrospective analysis was performed on clinical and imaging characteristics and prognosis of8cases who were diagnosed as Heat stroke and received treatment during July and August in2010and2013at the second hospital of shandong university.RESULTSAmong them,7cases are male,2case are female, onset age from47to87Y, an average age of63.89±13.10,all patients are admitted with Core body temperature at39.8℃～42.5℃. within24h,All patients presented with different degree of coma,2cases of acute cerebral infarction,2case of symptomatic epilepsy, acute respiratory failure in2cases,8cases of acute myocardial injury,8cases of acute liver damage,6cases of acute kidney injury,4cases of upper gastrointestinal bleeding, rhabdomyolysis in3case, decompensated respiratory alkalosis and metabolic acidosis in1case and6cases of electrolyte disorder. Cerebral MRI showed diffuse brain swelling in6cases and2Cases of the acute cerebral infarct. All patients are gived cooling, rehydration, anticoagulation, symptomatic treatment, etc. After treatment,One case was dead, two cases were cured, and others had different degree of neurological sequelae.CONCLUSIONSHeat stroke can lead to multiple organ failure and conscious disorder, with characteristics of high mortality, high morbidity and images performance is clearly lighter than clinical symptoms of nervous defect. Early identifying heat stroke, rapidly expansion and cooling and improving cerebral edema is the key to rescue successfully.