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患者,女性,24岁,右侧肢体麻木、无力2天,发作性四肢抽搐,伴意识丧失及尿失禁,每次持续1分钟,入院前12小时抽搐频繁发作,其间意识丧失无恢复。半月前,足月顺产女婴一名,无大出血。入院查体:血压14/10kPa,中度昏迷,瞳孔等大,对光反射佳。双侧视乳头边界消失,中央静脉扩张。压眶右侧鼻唇沟浅,右侧肢体无反应,左侧上、下肢略能活动。四肢肌张力低,腱反射消失,病理征未引出。无头皮水肿。血白细胞18×10~9/L,中性粒细胞0.87,血小板110×10~9/L。出凝血时间均为30s,头颅CT扫描:两侧皮层及皮层下广泛低密度影以左额、顶叶为著,其间散在高密度影,中线及左侧钩回向右移位。诊断:上矢状窦血栓形成。给予消栓灵0.56u/d静脉点滴,同时给予抗菌素、甘露醇、激素常规治疗。第6天意识好转,恢复。但失语,右侧肢体完全性瘫痪,
Patient, female, 24 years old, right limb numbness, weakness 2 days, seizure of limbs, loss of consciousness and urinary incontinence for 1 minute each. Frequent episodes of convulsions 12 hours prior to admission, during which loss of consciousness did not recover. Half a month ago, full-term birth of a baby girl, no major bleeding. Admission examination: blood pressure 14 / 10kPa, moderate coma, pupils and other large, good light reflection. Bilateral nipple border disappeared, central venous dilatation. Pressure orbital right nasolabial groove shallow, right limb no response, the left upper and lower extremity slightly active. Limb muscle tension is low, the tendon reflex disappears, the pathological sign does not lead. No scalp edema. Blood leukocytes 18 × 10 ~ 9 / L, neutrophils 0.87, platelets 110 × 10 ~ 9 / L. The clotting time is 30s, cranial CT scan: both sides of the cortical and subcortical extensive low-density shadow to the left forehead, the parietal lobe, interspersed with high-density shadow, midline and the left hook back to the right shift. Diagnosis: upper sagittal sinus thrombosis. Give suppositories 0.56u / d intravenous drip, while giving antibiotics, mannitol, hormones routine treatment. Day 6 consciousness improved, recovery. However, aphasia, the complete paralysis of the right limb,