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患者,男性,12岁。因头痛呕吐近1个月,在当地按“病毒性脑炎”治疗病情未见好转而转院。病程中渐感右侧肢体无力,右手不能握筷等,无抽搐及大小便失禁。体检:神清,一般情况好,双侧瞳孔等大等圆,光反射好,生命体征平稳。BP 14/9 kPa,HR 80/min,颈软,眼底检查见双侧视乳头水肿,右侧肢体肌力Ⅳ级,病理征(-)。头颅CT见左额叶中央区占位;磁共振:左额叶见团块状异常信号,T_(1w)、T_(2w)均呈等信号,周围境界清,增强明显均匀强化,其内见点状囊变区,外周水肿明显,同侧胼胝体受侵,脑室受压中线移位,意见:左额叶占位,胶质瘤可能性大,脑外肿瘤不能完全排除。手术所见:颅内压略高,脑血管搏动良好,左额叶肿瘤,色白,质较韧,大小约5×4×4 cm~3,肿瘤境界清楚与组织
Patient, male, 12 years old. Vomiting for nearly 1 month due to headache, according to the local “viral encephalitis” treatment of the disease did not improve and transferred. In the course of his illness, he gradually felt weak on the right limb, his right hand could not hold chopsticks, etc., and did not convulsions and incontinence. Physical examination: God clear, the general situation is good, such as the bilateral pupil round, light reflection, vital signs stable. BP 14/9 kPa, HR 80 / min, neck soft, fundus examination showed bilateral papilledema, right limb muscle strength grade Ⅳ, pathological sign (-). Head CT showed the left frontal lobe central area occupying; MRI: the left frontal lobe see block abnormal signal, T_ (1w), T_ (2w) showed equal signal, the surrounding realm clear, enhanced significantly enhanced, see Point-like cystic area, peripheral edema, ipsilateral corpus callosum invasion, ventricular compression midline displacement, views: left frontal mass, the possibility of glioma, brain tumors can not be completely ruled out. Surgical findings: slightly higher intracranial pressure, cerebrovascular pulsation is good, left frontal lobular tumor, white color, quality and tough, the size of about 5 × 4 × 4 cm ~ 3, clear tumor and tissue