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女性58岁.因头昏20年,左眼视物模糊3个月,伴恶心、下肢站立不稳于1991年12月24日住入本院.体检:左眼底视乳头水肿,右眼失明,伸舌舌尖偏右侧,步态不稳,无偏瘫,巴彬斯基征(-).头颅X线片示左前额鸡蛋大小高密度阴影.CT片示左前额脑内有一6cm×5cm高密度块影,中线右偏,增强扫描,块状影密度增高,诊断左额叶大脑镰窦旁脑膜瘤.术中见肿瘤压迫左额叶中部皮层,蒂位于大脑镰、矢状窦旁.肿瘤切除后,额叶脑组织明显塌陷,瘤窝前缘增粗的大脑上静脉、桥静脉因塌陷脑组织牵拉和术中操作被撕裂出血,因而夹闭该桥静脉,此后术区脑组织明显膨起伴静脉淤血.创面渗血增多,经止血、置引流管、缝合硬脑膜后见张力尚可,作颅骨瓣修复.术后28小时病情恶化,再次手术探查,剪开硬膜,见脑膨出、瘤窝液化碎裂的脑组织涌出,予以清除,去骨瓣减压.术后病理报告砂瘤型脑膜瘤.随访28个月,病人恢复家务劳动.
Female 58. Due to dizziness for 20 years, left eye blurred vision for 3 months, with nausea, lower extremity standing instability in December 24, 1991 admitted to our hospital.Physiological examination: the left fundopause papilledema, right eye blindness, Extend tongue tongue to the right side, unsteady gait, no hemiplegia, Babinski sign (-) .Cranial X-ray showed high-density shadow of the left frontal egg size .CT film showed a 6cm × 5cm high density Block shadow, midline right deviation, enhanced scan, block shadow density increased diagnosis of left frontal cortex of the paraneoplastic meningioma surgery see the tumor oppression of the left frontal cortex, pedicle in the falx, sagittal sinus tumor resection After the frontal lobe brain tissue was significantly collapsed, trophoblastic front thickening of the upper cerebral vein, bridge vein collapsed brain tissue traction and intraoperative manipulation was torn bleeding, and thus clamping the bridge after the brain tissue was significantly Swelling with venous congestion increased wound bleeding, bleeding, drainage tube, see the tension after the dural suture can still be used for skull flap repair. 28 hours after the disease deteriorated again surgical exploration, cut the dura mater, see the brain Bulging, nodular liquefaction fragmentation of brain tissue emission, to be cleared, bony flap decompression .Postoperative pathology report of meningioma meningioma .Follow-up 2 8 months, the patient resumes housework.