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本例特点如下:①病前曾有病毒感染的前驱症状;②在前驱症状之后,起病较急,出现头痛、恶心,视乳头水肿之颅内压增高征象;③有较急出现的脑部局限性损害的症状与体征;④周围血象白细胞及中性粒细胞计数轻度增高;⑤辅助检查(脑超声波、脑电图、脑血管造影、脑室造影)有异常发现。本例主要的临床征象是颅内压增高及脑实质的局灶性损害。鉴别诊断需考虑以下几个疾病:一、脑肿瘤本例有进行性加重的头痛,夜间加重,伴有恶心及视乳头水肿;有脑局灶性损害的体征,如左偏瘫及左半身感觉障碍、脑超声波中线左移、脑电图示右顶局限性慢波病灶等。颈动脉造影及脑室造影均支持为右顶部占位病变,而类似脑肿瘤,但病前有病毒感染,又有较急性出现的脑实质的局限性损害及较急性出现的颅内压增高,周围血象白细胞及分类中性粒细胞轻度增加,这在脑瘤病人中似又少见。二、脑血管意外本例起病较急,有头痛、恶心,半身感觉及运动障碍,与脑血管病有些类似,但后者多为老年人,常有高血压病史及动脉硬化症,起病多急骤,似又不符。
The characteristics of this case are as follows: ① there was a precursor of virus infection before the disease symptoms; ② in the prodromal symptoms, more acute onset, headache, nausea, papilledema intracranial pressure signs of increased; ③ emergencies of the brain Limitations and signs of damage; ④ peripheral blood leukocytes and neutrophils count slightly increased; ⑤ auxiliary examination (brain ultrasound, EEG, cerebral angiography, ventricular angiography) abnormal findings. The main clinical signs of this case are increased intracranial pressure and focal parenchymal lesions. Differential diagnosis should consider the following diseases: First, brain tumors in this case progressive headache, aggravated at night, accompanied by nausea and papilledema; signs of focal brain lesions, such as left hemiplegia and left hemiplegia , Left brain ultrasound shift, EEG top right limited limited slow wave lesions. Carotid angiography and ventriculography are supported by the right top of the occupying lesion, and similar brain tumors, but pre-existing viral infection, there are more acute limitations of the brain parenchymal damage and more acute increase in intracranial pressure, around Blood leukocytes and the classification of mild neutrophils increased, which seems rare in patients with brain tumors. Second, the cerebrovascular accident in this case more acute onset, headache, nausea, half body feeling and dyskinesia, and some similar to cerebrovascular disease, but the latter mostly elderly, often with hypertension and atherosclerosis, More flashy, it seems not match.