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男,64岁,1985年10月24日因头部外伤,呕吐二小时入院。患者在24日上午9时左右,饮白酒2两,30多分钟去厕所时跌倒,左枕部撞伤,20分钟后头痛,呕吐胃内物,喷射性。查体:体温35.5℃,脉搏84次/分,呼吸18次/分,血压130/90mmHg,神志清楚,言语流利、左枕部皮肤有2Cm长伤口,皮下血肿2×3cm。颅神经无异常。右下肢肌力略弱,颈强(+)。无其它神经系统体征。入院后喷射性呕吐2次。夜间24时,意识不清,右瞳孔直径4mm,左瞳孔直径2mm,光反射消失,双下肢巴彬斯基征阳性。25日上午头颅
Male, 64 years old, October 24, 1985 due to head injury, vomiting two hours admitted. Patients at about 9 am on the 24th, drinking liquor two two, more than 30 minutes to the toilet when the fall, the left occipital injury, headache after 20 minutes, vomiting stomach stuff, jet sex. Examination: body temperature 35.5 ℃, pulse 84 beats / min, breathing 18 beats / min, blood pressure 130 / 90mmHg, conscious, fluent speech, left occipital skin 2Cm long wounds, subcutaneous hematoma 2 × 3cm. No abnormal cranial nerve. Right lower extremity muscle weakness, neck strong (+). No other signs of the nervous system. After injection vomiting 2 times. 24 o’clock at night, unconsciousness, the right pupil diameter 4mm, left pupil diameter 2mm, light reflex disappeared, both lower limb Babinski sign positive. 25th morning skull