病例报告例 １．女性,５５岁。以突发意识障碍４ｈ入院,伴呕吐咖啡样物,尿失禁。既往有风心病、心房纤颤史３０年。入院时查体:浅昏迷,双眼球水平徘徊运动,双瞳孔直径３ｍｍ,光反应迟钝,双上肢屈曲状,双下肢强直状,肌张力增强,双侧Ｂａｂｉｎｓｋｉ征(＋),颈强(＋)。头颅ＣＴ:脑实质未见异常。外周血白细胞１３．１×１０９·Ｌ－１,血糖１１．４ｍｍｏｌ·Ｌ－１,心电图示不纯性房扑。按脑 Case report 1. Female, 55 years old. To sudden disturbance of consciousness 4h admission, with vomit coffee samples, urinary incontinence. Past rheumatism, atrial fibrillation for 30 years. Admission examination: shallow coma, eyes wandering the level of movement, double pupil diameter 3mm, photopic reaction, double upper limb flexion, double lower extremity ankylosis, muscle tension, bilateral Babinski sign (+), neck strength . Head CT: no abnormal parenchymal brain. Peripheral blood leukocytes 13.1 × 109 · L-1, blood glucose 11.4mmol · L-1, ECG impure atrial flutter. Press the brain