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例1,男,52岁,无诱因头痛、右侧肢体偏瘫、麻木、口角歪斜、吐词不清二月,于92年4月8日入院。查体:反应迟钝,回答问题准确。颈软无抵抗。心肺腹部无阳性体征。神经系统检查:右侧肢体痛觉减弱,右侧上下肢肌力Ⅳ级,双侧膝反射亢进,右巴彬斯基征(±)。腰穿示:无色透明脑脊液,脑压正常,常规、生化检查未见异常。头颅拍片未见异常。眼底检查有动脉硬化表现。诊断:脑血栓形成。给予扩管、抗凝、对症治疗一月,病情明显好转,右侧肢体肌力恢复正常。但5月7日又突然出现头痛,并有加重趋势,再次查眼底,见眼底视乳头模糊、考虑颅内肿瘤。颅脑 CT证实:左侧脑瘤。
Example 1, male, 52 years old, had no incentive to have a headache, hemiplegia on the right limb, numbness, skewed mouth, unclear articulation February, admitted to hospital on April 8, Physical examination: unresponsive, accurate answer to the question. Soft neck without resistance. Cardiopulmonary abdomen no positive signs. Nervous system examination: the right side of the lower limb pain, upper right and lower limb muscle strength grade Ⅳ, bilateral knee hyperreflexia, right Babinski sign (±). Waist wear: colorless transparent cerebrospinal fluid, normal brain pressure, routine, biochemical tests showed no abnormalities. No abnormal cranial filming. Fundus examination showed atherosclerosis. Diagnosis: Cerebral thrombosis. Give expansion, anticoagulation, symptomatic treatment January, the condition was significantly improved, the right limb back to normal muscle strength. However, on May 7, there was a sudden headache and aggravating trend. Once again, we examined the fundus and found the optic nerve in the fundus blurred and considered the intracranial tumor. Brain CT confirmed: left brain tumor.