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患者,男38岁。因头痛12d、视力差6d伴左肢体无力4d入院。头痛剧烈,枕及前额部尤甚并伴呕吐。体检:神清,双眼失明,左瞳孔3mm、右瞳孔5mm,右侧直接、间接光反射均消失,右上脸下垂,双眼右同向凝视。左上下肢张力低,肌力2级。无感觉障碍,左侧腱反射减弱,病理征阴性。双侧眶上神经及左枕大神经压痛明显。入院后多次查血糖显著增高,尿糖>++,Ch7.76mmol/L,TG5.53mmol/L。病后半月、1.5月、4月脑CT扫描均示右颞、枕叶大片低密度灶。经脱水、扩管扩容、降血糖血脂及对症处理,住院48d症状改善而出院。4月后左手不自主搓丸样动作,半年后再住我科。
Patient, male, 38 years old. Due to headache 12d, poor eyesight 6d with left limb weakness 4d admission. Severe headache, pillow and forehead, especially with vomiting. Physical examination: God clear, his eyes blind, left pupil 3mm, right pupil 5mm, right side of the direct, indirect light reflex disappeared, the right face drooping, eyes staring at the same direction to the right. Left lower limb tension is low, muscle strength 2. No sensory disturbances, left tendon reflexes, pathological signs negative. Bilateral supraorbital nerve and left occipital nerve tenderness significantly. After admission, check the blood sugar was significantly higher urinary sugar> ++, Ch7.76mmol / L, TG5.53mmol / L. After the disease half a month, 1.5 months, April brain CT scan showed the right temporal, occipital lobe large low-density lesions. After dehydration, expansion tube expansion, hypoglycemic and symptomatic treatment, hospitalized 48d symptoms improved and discharged. After April left involuntarily rub the pill-like action, and then live in our department after six months.