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病历摘要男性,15岁,于1979年11月29日因头痛一月而入院。入院前开始有头晕、眼花,而后出现复视,视力模糊,头痛伴有呕吐,分别于11月5日、18日及24日三次出现四肢强直性抽搐,每次持续一分钟不缓解。于25日卧床不起,不能说话,反应差,面部无表情,听力几乎完全消失。12月1日开始不思饮食、便秘、小便失禁。既往无特殊发现。体检血压126/80mmHg,脉搏68次/分,呼吸18次/分,双侧视乳头水肿充血,边界模糊不清,视野测不出,瞳孔等大形圆,对光反应迟钝,Ⅴ及Ⅶ对颅神经无异常,肌力左右均为3～4度,感觉减弱,肱二头肌及肱三头肌反射为(+),左右腹壁、提睾、膝蹠反射均为(+),颈强直(++),布氏征及克氏征(±)。化验室检查:血色素15克%,白细胞12600/立方毫米,中性80%,淋巴20%,腰穿发现脑脊髓液无色,清,潘氏试验(±),糖40～50毫克%,细胞数4个/立方毫米。自12月2日开始颅内压明显增高,呼吸变深而慢,瞳孔右侧稍大于左侧。12月3日脑室造影发现两侧脑室球形扩大,并向两侧分离,第三脑室未显影,拟诊为第三脑室肿瘤。未经手术于下午3时40分呼吸心跳停止,抢救无效死亡。
Medical summary Male, 15 years old, was admitted to hospital on January 29, 1979 due to a headache in January. Pre-admission dizziness, vertigo, and then diplopia, blurred vision, headache associated with vomiting, respectively, on November 5, 18 and 24 were three twitches limbs, each lasting one minute does not ease. Bedridden on the 25th, can not speak, the reaction is poor, facial expressions, almost completely disappeared hearing. December 1 does not think diet, constipation, urinary incontinence. No special findings in the past. Physical examination blood pressure 126 / 80mmHg, pulse 68 beats / min, breathing 18 beats / min, bilateral papilledema congestion, the boundary blurred, the vision can not be measured, the pupil and other large round, unresponsive to light, Ⅴ and Ⅶ Cranial nerves without abnormalities, muscle strength are about 3 to 4 degrees, weakened, biceps and triceps reflexes (+), left and right abdominal wall, cremaster, knee plantar reflex (+), neck stiffness (++), Brinell sign and Krypton sign (±). Laboratory tests: 15% of hemoglobin, 12600 / mm3 of leucocytes, 80% of neutral, 20% of lymphatic fluid, colorless, clear and PAN test (±) Number 4 / cubic millimeter. Since December 2 began significantly increased intracranial pressure, the breath becomes deeper and slower, slightly larger than the left pupil right. December 3 ventricular angiography found that both sides of the enlarged spherical ventricle, and to both sides of the separation, the third ventricle was not developed, to be diagnosed as third ventricle tumors. Respiratory heartbeat was stopped without surgery at 3:40 p.m. and the rescue was ineffective.