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ID:1339389
大小:64.00 KB
页数:12页
时间:2017-11-10
《英语神经外科病例及英汉神经外科词汇》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、英语神经外科病例及英汉神经外科词汇Case4:Posteriorfossasubduralhematomainneonate Thisnewbornfemalewasbornatagestationalageof40weeks,weighing3780,toagravida2para1mother.Forcepswereappliedtothefetalheadforfailuretoprogress.Apgarscoreswere6and9.withinthe1stdayoflife,thebabywasobservedt
2、obelistlessandlethargicandtohaveapoorsuck.Theanteriorfontanellewastense.Seizuresdeveloped.Endotrachealintubationandventilationwererequiredforbradycardiaandapneicepisodes.Thehemogramwasnormal.Alumbarpuncturewasperformedtoruleoutcentralnervoussystemsepsis,andbloodycer
3、ebrospinalfluidwasobtained.CTwasthenperformed,andalargePFSDHwasobservedinadditiontomoderateventriculomegaly.Aneurosurgicalconsultationwasobtained.Theneonatewasquadriplegiconaventilator,makingonlytheoccasionalrespiratoryeffort.Theneonatewastakenurgentlytosurgery,anda
4、posteriorfossacraniectomywasperformed.Theclotcouldberemovedfromtheposteriorfossasubduralspace.Thebleedingsiteswereidentifiedandsuccessfullycoagulated.Theinfantdidnotrequireanexternalventriculardrainnordidshegoontodevelopprogressivehydrocephalus.Shebegantobreatheread
5、ilyaftertheposteriorfossadecompressionandclotevacuationn.Shewasweanedfromtheventilatorwithin4days.SubsequentCTshowedminimalleftcerebellarparenchymainvolvementwithcalcificationandvolumeloss.Theventriculomegalyhadresolvedcompletely.At4yearsofaged,thecildwalkedandtalke
6、dnormally.Arightesotropiaremainedthathadpersistedsincesurgery.新生儿后颅窝硬膜下血肿一位妊娠两次生育一胎的母亲,在怀孕四十周后生下了一个重3780克的女婴,在胎头娩出不顺利时应用了产钳,Apgar评分为6和9。在生后的第一天,她吮吸较差并且嗜睡,精神萎靡,前囟门张力较高,抓握反射存在,由于心率过缓窒息,不得不应用气管插管通气,血象正常。为了除外小儿中枢系统脓毒症,进行了腰穿检查,可见血性脑脊液,行头CT检查显示患儿后颅窝硬膜下血肿,并且有轻微的脑室扩大,请神经外科会
7、诊。患儿四肢瘫,并且应用呼吸机辅助呼吸。患儿被快速送到神经外科,实行后颅窝开颅手术,血块被从后颅窝硬膜下清除,出血点被找出并且确切止血。患儿没有放置外引流,也未检出进展性脑水肿。在后颅窝血肿清除,压迫解除后,她恢复呼吸。四天后她脱离了呼吸机。复查CT可见左侧小脑实质小片钙化,体积缩小。脑室回复正常。小孩四岁时,可以正常走路说话,但在外科手术后就出现的内斜视仍然存在。Case5AstrocytomaoffrontallobeThepatientwasa48-year-oldmalewhopresentedwithcomplain
8、tsofincreasinglysevereheadaches.Workupatanotherhospitalrevealedalucentleftfrontallesion.ThebiopsydiagnosiswasgradeⅢastrocytoma.Hewasreferr
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