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1病例报告患者女,50岁。因头晕伴视物旋转、模糊5天,同时伴恶心呕吐、步态不稳入院。查体:血压100/65mmHg,双侧肌力5级,肌张力适中,痛温觉未见异常,腱反射未引出,无病理征。既往曾行胃大部及胆囊、胰头切除术。实验室检查:血红蛋白103g/L,低密度脂蛋白2.0mmol/L,余未见异常。头部CT检查未见异常。初步诊断为轻度贫血及脑供血不足。入院3天后出现视物重影,记忆力减退,意识和言语混乱。头部MRI检查:
1 case report Patients female, 50 years old. Due to dizziness with visual rotation, fuzzy 5 days, accompanied by nausea and vomiting, gait instability admitted to hospital. Physical examination: blood pressure 100 / 65mmHg, bilateral muscle strength 5, moderate muscle tone, pain and temperature no abnormalities, tendon reflex did not lead, no pathological signs. Past line most of the stomach and gallbladder, pancreatic head resection. Laboratory tests: hemoglobin 103g / L, low density lipoprotein 2.0mmol / L, I no abnormalities. Head CT examination showed no abnormalities. Initial diagnosis of mild anemia and cerebral insufficiency. Three days after admission, visual acuity, memory loss, awareness and speech disorder. Head MRI examination: