1病例报告患者男,40岁。因头痛、左侧肢体无力伴进行性加重8天入院。头痛为持续性胀痛,不放散,伴偶尔饮水呛咳、流涎等症状。查体:表情淡漠,左侧额纹、鼻唇沟变浅,口角向右歪斜,咽反射迟钝,左侧肢体肌力Ⅳ级,右侧Ⅴ级,双下肢肌张力均增高,双侧膝腱反射、跟腱反射亢进,双侧轮替 1 case report Patient male, 40 years old. Due to headache, left limb weakness with progressive 8 days admission. Headache is persistent pain, no discharge, with occasional drinking cough, salivation and other symptoms. Physical examination: apathetic expression, left frontal stripes, shallow nasolabial fold, mouth skewed to the right, slow pharyngeal reflex, left limb muscle strength grade Ⅳ, right Ⅴ grade, both lower extremity muscle tension were increased, bilateral knee tendon Reflex, Achilles tendon hyperreflexia, bilateral rotation