颅内静脉窦血栓误诊1例
Journal of Clinical Psychosomatic Diseases(2015)
Abstract
1 病例摘要 患者罗某,男,25岁,突发头痛4天,加重伴意识障碍1天入院,查体:昏睡状,查体欠合作,双侧瞳孔等大等圆3mm,双侧瞳孔对光反射灵敏,心肺腹(-),四肢肌力5级,肌张力正常,颈阻可疑(+),克氏征(-),布氏征(-),皮肤划痕症阴性,双侧病理征(-).曾急送当地医院行急诊头颅CT提示:小脑幕、纵裂池增宽,期内可见条形高密度影,边界模糊.考虑蛛网膜下腔出血,经相关治疗后病情无好转,遂入我院.辅查:血常规、脑脊液常规、生化、涂片、培养未见异常,结缔组织抗体筛查(-),磷脂综合征抗体(-),凝血功能未见异常.头颅MRI:双侧脑室周围及半卵圆中心见多发斑点状、板块状异常信号影,T1W1呈高信号,T2W1、T2FLAIR及DWI呈高信号;脑实质内未见异常信号影,灰白质分界清晰.
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