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患者男性,38岁,因头晕、行走不稳、言语不清6年,排尿费力一年,于1991年1月16日入院.患者于6年前,无明显诱因出现头晕、言语不清,双下肢无力,二年后,双下肢无力加重,走路不稳,以踏棉花感,性功能减退,当时侧血压为12/7kPa,在当地医院按“脑血栓”治疗,病情不见好转,走路不稳,言语不清,逐渐加重,走路时经常前倾而跌倒,近一年来,排尿费力,既往:健康,否认家族史。查体:T36℃,P96次/分,R18次/分,血压,卧位12/8.4kPa,立位9.6/5kPa,神志清,言语含糊不清,记忆力、计算力尚好,眼底正常,双软腭抬举有力,咽反射双侧减弱,余颅神经未见异常。双下肢肌力略弱、肌张力高、双膝腱反射活跃、踝震挛(+)、右侧 Babinski 氏征(+),chaddok 氏征(+)、左侧 Babinski 氏征(+)、双下肢音叉振动觉减弱、右侧提睾反射弱。双手指鼻稳准、轮替灵活、双侧跟膝胫不稳准,龙伯氏征(+)。辅助检查:腰穿脑脊液压力正常,压颈通畅、常规生化检查正常,头部 CT 扫描:鞍上池、环池扩大、小脑脑沟加深、双侧处侧裂扩大,大脑沟加深,其他血液化验均正常.
The male patient, age 38, was 6 years old due to dizziness, unsteadiness in walking, voiding and laboriousness for one year and was admitted to hospital on January 16, 1991. The patient had dizziness and speechlessness six years ago without any obvious incentive Lower extremity weakness, two years later, both lower extremities weakness, walking unsteady, with cotton feeling, sexual dysfunction, when the lateral blood pressure of 12 / 7kPa, in the local hospital by “cerebral thrombosis” treatment, the condition did not improve, walking unsteadily , Slurred speech, gradually aggravating, walking often leaned forward and fall, the past year, urination laborious, past: health, deny family history. Physical examination: T36 ℃, P96 beats / min, R18 beats / min, blood pressure, lying 12 / 8.4kPa, standing 9.6 / 5kPa, clear consciousness, verbal ambiguity, memory, computing power is still good, fundus normal, double soft palate Lift powerful, both sides of the pharyngeal reflex, I cranial nerves no abnormalities. (+), Babinski’s sign (+), Chaddok’s sign (+), Babinski’s sign (+) on the left side, double-breasted tendon, Lower extremity tuning fork vibration decreased weakness, right cremaster reflected weak. Finger nostril with both hands, flexible rotation, both sides with knee shinless accurate, Long Bo’s sign (+). Auxiliary examination: lumbar puncture cerebrospinal fluid pressure is normal, pressure neck unobstructed, normal biochemical tests are normal, head CT scan: suprasellar cistern, enlarging the cistern, deepening of the cerebellar sulci, flank enlargement at both sides, deeper sulci, other blood tests All normal.