注射玻尿酸隆鼻致左眼失明、混合型卒中1例

正1病例介绍患者,女,31岁,主因"突发左眼失明、右上肢肢体无力伴言语不清5 d"于2015年1月20日收入首都医科大学附属北京天坛医院。住院5 d前患者于隆鼻手术注射玻尿酸(hyaluronic acid,HA)时出现左眼失明,右上肢无力无法抬起,也无法平移,言语表达不能但可理解他人言语,伴头晕呕吐,呕吐物为胃内容物。外院头颅计算机断层扫描(computed tomography,     

原发性血小板增多症致颅内静脉窦血栓形成一例

正1病例资料患者,女性,24岁,主因"左眼视物模糊1个月"于2015年12月就诊本院神经内科。患者1个月前于劳累、情绪紧张后出现左眼视物模糊,伴左眼眶周痛,偶有恶心,视物模糊逐渐加重,无头痛、呕吐、一过性黑蒙、耳鸣、视物成双、四肢麻木无力等,外院诊断"视神经炎",并给予激素冲击治疗,上述症状一度曾有好转,但激素减量过程中左眼视物模糊再次加重。既往史:体健,否认外伤史和手术史,否认     

颈动脉蹼导致易损性斑块表面血栓形成继发脑梗死1例超声诊治思路

<正>1病例介绍和诊疗思路患者男性,59岁,主因“突发左侧肢体无力伴言语不清5天,加重1天”入院。患者5天前（2022-09-14）安静状态下无明显诱因突发左侧肢体无力,上肢不可抬举,无法独自站立,伴吐字含糊,可完全理解他人语言,左侧口角下垂。否认饮水呛咳、头晕、头痛、恶心、呕吐,否认视物旋转、视物成双等,否认心慌等不适。就诊于首都医科大学附属北京天坛医院急诊科,行头颅CT检查未见出血,考虑“急性脑梗死”,     

纯红细胞再生障碍性贫血导致良性颅高压一例

患者女性，39岁，因“头晕耳鸣2个月，头痛1个月，加重伴视力障碍10d”于2005年5月9日入院。患者2个月前无明显诱因出现头晕及双侧耳鸣，无视物旋转及听力下降。1个月前出现头痛，为全脑持续性胀痛，无恶心、呕吐。10d前患者出现视物模糊，左眼在2d内失明，右眼视力在近2～3d下降明显。起病以来无发热。体重下降2．5奴。患者2002年2月行胸腺瘤切除术，后每年复查一次胸部CT未见复发。否认结核病史。查体：体温36．3~C，血压110／70mmHg（1mmHg=0．133kPa），心率88次／min，睑结膜苍白。意识清楚，语言流利，左侧瞳孔直接对光反射消失，间接对光反射灵敏，右侧瞳孔直接对光反射灵敏，伸舌居中，颈软，Kernig征阴性，四肢肌力肌张力正常，双侧病理征未引出。视力：左眼失明，右眼视力0．3，眼底检查示双侧视乳头水肿，边缘模糊。     

Chiari畸形合并脊髓空洞症一例

<正>患者男性,63岁。主因间断头痛、头晕1年,加重2个月就诊于我院神经内科。既往高血压病史1年,否认手术、创伤史,家族中无类似患者。患者于1年前无明显诱因间断出现头痛,表现为全脑胀痛,伴有头晕,表现为头部晃动感,持续时间不等,短时可持续约10min,最长可持续3⁵d;不伴视物旋转、恶心、呕吐、吞咽困难、饮水呛咳、肢体无力、麻木疼痛及无大小便     

蝶鞍内脓肿一例报告

患者,女性20岁,81年10月因头痛、头晕、乏力、食欲不振,视物不清,在某医院诊断为颅咽管瘤行手术治疗。术后一周拆线刀口愈合尚好而出院,出院后头痛消失,视力恢复正常,能参加一般农业生产。于82年又出现头痛、头晕、恶心呕吐,右眼视物不清,诊断为颅咽管瘤术后复发来我院治疗。查体:体温37℃,脉搏82次/分,血压120/80,神清,语明,颅神经见眼球向左侧活动受限。左眼失明,右眼视力0.3,眼底视神经乳头苍白,边界     

鼻窦炎症致前床突脓肿1例

1病历摘要（图1）男，58岁，阵发性头痛伴左眼失明15d。15d前无诱因出现头痛，左眼视物模糊伴复视。无发热，次日出现恶心，喷射状呕吐2次，随即左眼失明。查体：左眼无光感，瞳孔直径4mm，无突眼，压痛与眶周痛阴性，直接对光反射消失，     

前庭性偏头痛一例

患者 女性,48岁.主因反复眩晕发作3天,于2020年3月11日入院.患者入院前3天劳累后出现眩晕、视物旋转,伴恶心、呕吐.眩晕反复发作,转头及起立后明显,休息后逐渐缓解,每次发作1～2小时、每日 发作频次逾6次.为求诊治遂至我院就诊,门诊以"头晕待查"收入神经内科.患者否认耳鸣、耳聋或听力下降,否认视物重影,不伴头痛...     

溃疡性结肠炎合并坏疽性脓皮病、脑静脉窦血栓1例报告

<正>1病例介绍患者,女,58岁,因"头晕5 d,发作性意识丧失伴肢体抽搐1 h"于2013年11月13日转入我院神经内科。患者因坏疽性脓皮病于2013年10月15日于我院皮肤科住院治疗,期间于2013年11月8日无诱因出现头晕,无视物旋转,无耳鸣及肢体力弱,无头痛、恶心、呕吐等不适。神经系统查体无明显异常,Glasgow评分15分。计算     

Percheron动脉闭塞致双侧腹内侧丘脑综合征2例报告

正1临床资料例1,男性,51岁,因"突发头晕、视物重影、嗜睡10 d"入院。患者入院10 d前无明显诱因突然出现头晕,无视物旋转,四肢无力,摔倒在地,当时无意识障碍,家属诉当天下午出现睡眠时间长,睡眠深,呼之能应,反应迟钝,肢体反应差,不伴头痛、呕吐,无二便失禁,到当地医院查头部CT示双侧基底节腔隙性脑梗死,为求进一步诊治转到我院。否认高血压病、糖尿病、心脏病,无吸烟、饮酒史,入院查体:血压144/     

Cerebral abscess with astrocytoma

A child with a right parieto-occipital astrocytoma, caped by a large acute pyogenic abscess with flimsy capsule, detected at emergency craniotomy, is presented. Patient succumbed to the disease three hours following surgery.     

Severe Reversible Cerebral Vasoconstriction Syndrome with Large Posterior Cerebral Infarction

Reversible cerebral vasoconstriction syndrome is characterized by thunderclap headache and multifocal cerebral vasoconstriction. Cerebral vasoconstriction is reversible, and most cases have good prognosis. However, clinical outcome is possibly severe when it is complicated by stroke, yet detailed reports on such a case are few. We experienced a case of severe reversible cerebral vasoconstriction syndrome in a 32-year-old woman with medical history of preeclampsia 3years prior. She presented with sudden sharp headache followed by altered mental status and vasoconstriction of the bilateral posterior cerebral arteries. She was treated with intravenous and oral calcium channel blockers, edaravone, and glycerol. However, the cerebral infarction in the posterior circulation subsequently remained, and her impaired consciousness did not recover. Furthermore, although imaging findings of vasoconstriction showed improvement a day after the occurrence of symptom, the same vessels showed poor visualization 7 weeks later, which indicated the recurrence of vasoconstriction, without additional symptom due to the fixed infarction. Although most cases of reversible cerebral vasoconstriction syndrome show good prognosis, neurologists must monitor the possibility of worse clinical course and permanent neurological deficit when associated with stroke, such as cerebral infarction. Strict management and treatment are needed in these cases.     

Cerebral edema associated with meningioma

Cerebral edema associated with meningiomas is a rather common phenomenon. A patient with a small meningioma presented with severe cerebral edema, out of proportion to the size of the tumor. During surgery the meningioma was removed and the adjacent edematous brain tissue biopsied. The histopathological study showed conspicuous plasma cell and lymphocyte infiltration in both the tumor and the cerebral edematous tissue. The pathological findings are presented, and the possible mechanism for cerebral edema associated with meningioma is discussed.