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患者女,30岁,农民。因间歇性双上肢麻木疼痛三年,发作性头昏一年,昏倒后失语,伴右侧肢体偏瘫两天,以脑血管意外于1991年10月8日收住本院。查体:体温37℃,血压测不出,神志清楚,双侧挠动脉搏动消失。右侧中枢性面瘫、颈软,心率86/分,律齐。右侧肢体瘫痪、肌力0度、肌张力亢进,巴彬斯基征(+)。脑血液图为左右振幅明显不对称(大于30％),右侧脑血管弹性降低,报告脑梗塞。脑电图轻、中度异常。入院后诊断:(1)休克原因待查、肾上腺皮质危象?(2)脑血管意外——脑血栓性脑梗塞。给予大剂量激素并用扩容、纠酸、大剂量抗生素治疗。治疗一周病情无明显变化,血压仍为0,但患者神志正常,
Female patient, 30 years old, farmer. Due to intermittent upper limb numbness pain for three years, onset of dizziness for a year, after a fainting aphasia, with the right limb hemiparesis two days to cerebrovascular accident in October 8, 1991 admitted to the hospital. Physical examination: body temperature 37 ℃, blood pressure can not be measured, conscious, bilateral pulsed arterial pulse disappeared. The right side of the central paralysis, neck soft, heart rate 86 / min, law Qi. Paralysis of the right limb, muscle strength 0 degrees, hyperthyroidism, Babinski sign (+). Cerebral blood flow showed a significant asymmetric amplitude (greater than 30%), decreased right cerebral vascular elasticity, reported cerebral infarction. EEG light, moderate abnormalities. Post-hospital diagnosis: (1) the cause of shock to be investigated, the adrenal crisis? (2) cerebrovascular accident - cerebral thrombotic cerebral infarction. Give large doses of hormone and expansion, correcting acid, high-dose antibiotic treatment. Treatment of the disease no significant change in the week, the blood pressure is still 0, but patients with normal consciousness,