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患者女,61岁。因“头痛10个月,再发加重18天”入院。患者11个月前无明显诱因出现头痛,呈阵发性胀痛,伴呕吐、步态不稳。专科体检:轮替试验不能合作,右侧指鼻试验(+),闭目难立征(-),跟膝胫试验可疑阳性。脑MRI平扫见右小脑大小约26 mm×21 mm×16 mm类圆形等T1、短T2信号影(图1、2),周围见片状长T1、长T2信号,增强扫描呈厚环状强化(图3~5),与右侧小脑幕关系密切(图4、5)。请分析病变性质。答案见第644页。
Female patient, 61 years old. Because of “headache for 10 months, and then heavier 18 days ” admission. Patients 11 months ago no obvious incentive to headache, paroxysmal pain, vomiting, unsteady gait. Specialized physical examination: Rotation test can not cooperate, the right finger nose test (+), closed eyes hard to establish the sign (-), suspicious positive with the knee tibia test. Cerebral MRI plain type of right cerebellum about 26 mm × 21 mm × 16 mm class round T1, short T2 signal shadow (Figure 1,2), see around the long flake T1, T2 signal enhancement scan was thick ring (Figure 3 ~ 5), and the right cerebellar close (Figure 4,5). Please analyze the nature of the disease. See page 644 for the answer.