由于CT扫描的应用,原发性脑瘤合并脑内出血的病例有所增加,但脑转移瘤合并脑内出血则较为少见。作者报告一例以脑内出血发病的肺癌脑转移的尸检结果。患者79岁,男,1981年7月出现常念错字,未引起注意,10月2日散步时被发现倒地、意识不清而入院。查体:神志清晰,能说出自己的姓名,定向力丧失,不能说出出生年月日。右侧同向偏盲,构音障碍,四肢肌肉普遍性萎缩,右上肢Barre征(十),尿失禁,不能站立,病理反射阴性。C T扫描颞叶后部及枕叶可见高密度区伴左半球广泛水肿。胸部X线示动脉硬化、陈旧性肺结核、肺气肿。镓闪烁检查可疑肺门至纵隔吸收增强。经吸氧、倍他米松治疗,右侧轻偏瘫、构音障碍及地点定向力曾好转,但对时间定向力仍有障碍、语言理解困难、说错话、 Due to the application of CT scan, there is an increase of cases of primary brain tumor with intracerebral hemorrhage, but brain metastases with intracerebral hemorrhage are rare. The authors report an autopsy result of a brain metastasis of lung cancer with intracerebral hemorrhage. 79 years old, male, July 1981 often misspelled, did not attract attention, October 2 was found lying on the ground walking, unconsciousness and admission. Examination: Consciousness, can say his name, loss of orientation, can not say the date of birth. Right hemianopia, dysarthria, generalized limb muscle atrophy, right upper limb Barre sign (ten), incontinence, can not stand, pathological reflex negative. C T scan of the temporal lobe and occipital lobe visible high-density area with extensive left hemisphere edema. Chest X-ray showed arteriosclerosis, old tuberculosis, emphysema. Gallium flashes check suspicious hilar to mediastinal absorption increased. After inhaled oxygen, betamethasone treatment, right hemiparesis, dysarthria and site orientation had improved, but still time-oriented power barriers, difficult to understand the language, to put it wrongly,