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患者,男性,60岁,某日下午站立,土墙倒塌,从身后撞击小腿,膝部屈曲,身体前移,而头过度后仰,随着身体的倒地,头又前倾撞击地面,致左前额皮肤擦伤,当时不省人事,立即被送往医院抢救。次日上午苏醒,但发现听力减退,脑电图示轻度弥散性异常。下肢及头颅拍片未发现骨折。诊为脑震荡。应用细胞色素C、能量合剂、输液等治疗。十天后四肢仍不能活动,行走困难而转入我院。检查:神志清醒,左侧Hornet氏征,双侧混合性耳聋,复聪试验阳性。左侧上、下肢肌力Ⅲ级。右侧Ⅴ~(-)级,四肢肌张力均增高,左侧明显。右侧C_4平面以下痛觉减退,左侧音叉震动觉及关节位置觉减退。肱二头肌反射左(卅)、右(廾),膝腱反射左(卅)、右(廾),左Babinski氏征(土)。脑脊液正常,颈椎摄片示轻度骨质增生外未见其他异常,头颅CT扫描未见异常。诊断:鞭击综合征脊髓症状型。给予低分子右旋糖酐500毫升,每日1次静滴,胞二磷胆碱O.5克,每日1次静滴,以及静滴能量合剂、口服脑复康等。治疗半月四肢肌力均恢复至Ⅴ级,带药出院。四个月随访,除听力未完全恢
Patient, male, 60 years old, standing on one day afternoon, wall collapsed, hitting calf from behind, knee flexing, body advancing, head overturning, with body falling to the ground, Left forehead skin abrasions, was unconscious, was immediately taken to the hospital for treatment. Wake up the next morning, but found hearing loss, mild diffuse EEG abnormalities. Lower extremities and cranial film did not find fractures. Diagnosed as concussion. Application of cytochrome C, energy mixture, infusion and other treatment. After ten days still unable to move the limbs, walking difficulties into my hospital. Check: conscious, left Hornet’s syndrome, bilateral mixed deafness, Fucong test positive. On the left, lower limb muscle strength Ⅲ. Right Ⅴ ~ (-) level, limb muscle tension were increased, the left obvious. On the right C_4 plane below the pain reduction, the left side of the tuning fork vibration feel and joint position feel diminished. Biceps reflex left (卅), right (廾), knee tendon reflex left (卅), right (廾), left Babinski’s sign (soil). Normal cerebrospinal fluid, cervical spine showed no other abnormal bone hyperplasia, no abnormal CT skull. Diagnosis: whip syndrome syndrome symptoms. Given low molecular weight dextran 500 ml, intravenous infusion once daily, citicoline 0.5 g, daily intravenous infusion, and intravenous infusion of energy mixture, such as oral rehabilitation of the brain. Half-month limb muscle strength were recovered to V level, with drug discharge. Four months follow-up, except for hearing is not fully restored