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患者男性,69岁,1960年诊断:垂体腺瘤。曾在外院放疗3疗程,1987年行垂体瘤切除术。病理报告:嗜酸性垂体腺瘤。1998年复查CT发现颅内多个肿瘤,未治疗。2000年11月因意识障碍、左侧肢体瘫痪、大小便失禁入院。查体:嗜睡、言语错乱。下颌、额、眶明显突出,唇厚。右面部痛觉减弱。左侧肢体深、浅感觉减退,肌张力增高,肌力Ⅰ-Ⅱ级,左肱二、三头肌腱反射亢进,巴彬斯基征（±）。头颅CT、MRI示蝶鞍扩大,但鞍区未见肿块影;右额、颞、顶、枕及左颞部有多个肿瘤性包块,且较前明显增大,CT增强呈均匀高密度影,MRI呈短T1长T2表现。胸部CT、腹部B超等未见异常。术前诊断:多发性脑膜瘤?2000-11-28在全麻下行开颅探查肿瘤切除术,全切除肿瘤15个,分别位于右额镰旁1个,镰旁中央沟静脉前1
Male patient, 69 years old, 1960 Diagnosis: pituitary adenoma. Had 3 courses of radiotherapy in the hospital, 1987 pituitary tumor resection. Pathology report: eosinophilic pituitary adenoma. CT review in 1998 found multiple intracranial tumors, untreated. 2000 November due to disturbance of consciousness, paralysis of the left limb, incontinence admission. Physical examination: lethargy, speech disorder. Jaw, forehead, orbital conspicuously prominent, lip thick. Right facial pain decreased. Left limb deep, shallow feel diminished, muscle tension increased muscle strength Ⅰ-Ⅱ grade, left brachial second, triceps tendon hyperreflexia, Babinski sign (±). Head CT, MRI showed sella enlargement, but there was no sellar mass in the sellar region. There were multiple tumor masses in the right frontal, temporal, top, occipital and left temporal regions, which were significantly larger than before Shadow, MRI showed a short T1 T2 performance. Chest CT, abdomen, B ultrasound and other anomalies. Preoperative diagnosis: Multiple meningioma? 2000-11-28 Under general anesthesia underwent craniotomy resection, total removal of the tumor 15, respectively, located in the right frontalis next to a sickle next to the central ditch 1