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6岁女孩,以阵发腹痛13天、双下肢无力10天为主诉入院,伴站立不稳,且半月前曾有呕吐。查体:双下肢肌张力低下,右下肢肌力0级,左下肢肌力近端Ⅱ级、远端Ⅰ级,膝腱反射未引出,脑脊液外观淡黄色,初压85mmH_2O,动力试验有梗阻,白细胞10个,蛋白1200～3250mg/dl,椎管造影示造影剂在第一腰椎体上缘受阻,呈“杯口状”,边缘粗糙,病灶位于右后,腰1椎体右侧椎弓根受压变高,诊断椎管肿瘤。入院12天突然昏迷,视乳头水肿,考虑脑疝作脑室引流,CT 检查为后颅凹
The 6-year-old girl was admitted to hospital with her abdominal pain for 13 days and weakness in her lower extremity for 10 days. She had unstable standing and had vomiting half a month ago. Physical examination: Lower limb muscle tone, right lower limb muscle strength 0, proximal left lower limb muscle II, distal I, knee tendon reflex no lead, cerebrospinal fluid appearance pale yellow, initial pressure 85mmH 2 O, dynamic test obstruction, 10 white blood cells, protein 1200 ~ 3250mg/dl, spinal angiography contrast agent in the upper edge of the first lumbar vertebral body was blocked, showing a “cup shape”, rough edges, the lesion is located in the right, the right pedicle of the lumbar 1 vertebral body Increased pressure, diagnosis of spinal canal tumors. Sudden coma 12 days after admission, papilledema, consider cerebral palsy for ventricular drainage, CT examination for the posterior cranial fossa