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患者女,19岁。10天前无明确诱因剧烈头痛(呈爆炸样),近3天头痛、头晕加重,伴恶心、呕吐,双眼视物模糊。体检:双眼视力粗测下降,双颞侧视野缺损。否认头部外伤史。曾因中枢性尿崩症(继发性)保守治疗。头颅CT平扫示鞍区团块状高密度影,其内密度欠均匀,边界尚清。两侧脑室、中脑导水管、第三脑室、第四脑室、枕大池亦可见条带状高密度影(图1A、B)。头颅MRI平扫示鞍区及脑室内团块状混杂信号影,其内信号不均(图2A、B);增强扫描示鞍区病灶强化不均,边界尚清,垂体增大,实质内未示明显异常强化信号影,垂体柄增粗。脑室内病灶无
Female patient, 19 years old. 10 days ago no obvious incentive for severe headache (was exploding), nearly 3 days headache, increased dizziness, with nausea, vomiting, binocular vision blurred. Physical examination: rough eyesight binocular decline, bilateral temporal defect. Denied the history of head injury. Have a conservative treatment of central diabetes insipidus (secondary). Head CT scan showed saddle area block-shaped high-density shadow, the density is less uniform, the boundary is clear. The lateral ventricle, midbrain aqueduct, the third ventricle, the fourth ventricle, and the occipital cistern were also visible with ribbon-shaped high density (Figure 1A, B). The cranial MRI showed the mixed saddle area and intracapsular mixed signal with uneven signal (Fig. 2A, B). The enhanced scan showed uneven enhancement of the lesion in the saddle area with clear boundary, increased pituitary gland, Shows significant abnormal signal enhancement, pituitary stalk thickening. No intraventricular lesions