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患者男性,38岁。因右侧肢体活动失灵17天,于1984年11月14日入院。患者病前因劳动后感右上肢麻木,渐觉同侧下肢无力。3日后口角向左歪斜,右手不能持物,下肢抬腿困难。检查发现右侧鼻唇沟浅,伸舌右偏,右肢体轻瘫,病理征阳性。脑脊液常规:正常。诊断:脑血栓形成,并予扩张血管剂治疗2周,体征明显恢复而出院。随诊一年中,能正常工作。1985年12月间,偶因戏耍,左面、颞部被碰伤,感局部肿、痛。一周后感右侧肢体无力,言语欠清,10天后就诊再入院。既往有血吸虫病、癫痫、头部外伤史。查体:体温36.8℃,脉搏80次,呼吸20次,血压124/80,神志清楚,颈软,右侧中枢性面,舌瘫,右侧肢体不完全性瘫痪,下肢重于上肢,腱反射右侧较对侧亢进,右侧巴氏征(+),余正常。住院后再以扩血管药治疗8天症状未见改善,并出现阵阵的裂开样头痛伴呕吐。眼底检查:视乳头水肿。脑电图见左侧导联呈现3c/sθ波和复形慢波。超声波检查:头颅中线移位1cm。头颅X线摄片正常。脑脊液压力高(未测压),常规:细胞数0.018×10~9/L(18/mm~3),
Male patient, 38 years old. Due to the right limb movement failure for 17 days, on November 14, 1984 admission. Patients with premorbid feeling of right upper limb numbness, gradually feel ipsilateral lower limb weakness. 3 days after skew skewed to the left, the right hand can not hold the goods, leg leg problems. Examination found that the right nasolabial fold shallow, tongue right deviation, right limb paralysis, pathological sign positive. Cerebrospinal fluid routine: normal. Diagnosis: Cerebral thrombosis and dilation of vascular agents for 2 weeks, signs of significant recovery and discharge. Followed up for one year, can work normally. December 1985, due to play, due to play, left, temporal bruising, sense of partial swelling, pain. A week later, the right limb weakness, lack of words, 10 days after admission and admission. Past history of schistosomiasis, epilepsy, head trauma. Physical examination: body temperature 36.8 ℃, pulse 80 times, breathing 20 times, blood pressure 124/80, conscious, soft neck, the right side of the central face, tongue paralysis, right limb incomplete paralysis, lower extremity in the upper limbs, tendon reflex Right than the contralateral hyperactivity, right side of the Pakistan’s sign (+), more than normal. Treated with vasodilator for 8 days after hospitalization did not improve the symptoms, and burst bursts of pain with vomiting. Fundus examination: papilledema. EEG see the left lead shows 3c / sθ wave and complex slow wave. Ultrasound examination: head shift 1cm. Head X-ray normal. High cerebrospinal fluid pressure (not measured), routine: cell number 0.018 × 10 ~ 9 / L (18 / mm ~ 3),