We report a case of complicated pansinusitis presenting with thunderclap headache. The patient quickly developed left ophthalmoplegia and imaging demonstrated extension of inflammation from the sphenoid sinus into the...We report a case of complicated pansinusitis presenting with thunderclap headache. The patient quickly developed left ophthalmoplegia and imaging demonstrated extension of inflammation from the sphenoid sinus into the sellar region. Thunderclap headache is well known to occur from a variety of intracranial events, but complicated sinusitis presenting this way is seldom described. The patient recovered completely with appropriate treatment.展开更多
A 45-year-old male cook was seen for the evaluation and removal of a "mole o n my eye" of steady growth during the previous 6 months. The patient stated that he had had a "brown spot" above his lef...A 45-year-old male cook was seen for the evaluation and removal of a "mole o n my eye" of steady growth during the previous 6 months. The patient stated that he had had a "brown spot" above his left eye for 17 years prior to its recent e nlargement; it was now partly blocking the vision in his left eye. He denied a h istory or family history of cutaneous tumors, including skin cancer. On examinat ion, a 2.5-cm ×.0.5-cm ×.0.8-cm, horn-like, darkly pigmented, cutaneous no dule was evident extending from the left upper eyelid downwards to below the low er eyelid (Figs 1 and 2). He also had scattered, skin-colored, 2-3-mm cystic papules on his anterior mid-chest. A shave excision specimen was obtained from the eyelid nodule. Microscopic examination demonstrated acanthosis, hyperkeratos is, and papillomatosis (Fig. 3). Large dendritic cells with abundant melanin gra nules were spread throughout the epidermis. In addition, small basaloid or spino us keratinocytes were present in the malpighian layer.展开更多
一个半综合征(The one and half syndrome)临床上少见,我科收治1例,经CT确诊为桥脑出血。报告如下: 患者女性、57岁、1991年11月排便后突然头晕,视物模糊,非喷射状呕吐胃内容物两次,家人扶上床后意识不清,尿失禁;4年前查体发现血压高,...一个半综合征(The one and half syndrome)临床上少见,我科收治1例,经CT确诊为桥脑出血。报告如下: 患者女性、57岁、1991年11月排便后突然头晕,视物模糊,非喷射状呕吐胃内容物两次,家人扶上床后意识不清,尿失禁;4年前查体发现血压高,但未予治疗。查体:血压26/18kPa,呈浅昏迷,颈强直,心肺腹部正常;双眼球不在同一水平,右侧低于左侧2mm;双瞳孔缩小,右侧直径1mm,左侧1.2mm,对光反射迟钝;四肢肌张力增高,右侧著,右上肢肌力Ⅳ级,下肢Ⅲ级,右侧腱反射亢进,Babinski征(+),入院后经降颅压,注射、静点胞二磷胆碱、牛黄醒脑注射液等治疗,于第三天转为嗜睡,视物呈双影,头晕明显。再查见左侧眼球呈中央位,不能内收外展;右侧眼球除呈外层位外,内收时不能过中线。展开更多
文摘We report a case of complicated pansinusitis presenting with thunderclap headache. The patient quickly developed left ophthalmoplegia and imaging demonstrated extension of inflammation from the sphenoid sinus into the sellar region. Thunderclap headache is well known to occur from a variety of intracranial events, but complicated sinusitis presenting this way is seldom described. The patient recovered completely with appropriate treatment.
文摘A 45-year-old male cook was seen for the evaluation and removal of a "mole o n my eye" of steady growth during the previous 6 months. The patient stated that he had had a "brown spot" above his left eye for 17 years prior to its recent e nlargement; it was now partly blocking the vision in his left eye. He denied a h istory or family history of cutaneous tumors, including skin cancer. On examinat ion, a 2.5-cm ×.0.5-cm ×.0.8-cm, horn-like, darkly pigmented, cutaneous no dule was evident extending from the left upper eyelid downwards to below the low er eyelid (Figs 1 and 2). He also had scattered, skin-colored, 2-3-mm cystic papules on his anterior mid-chest. A shave excision specimen was obtained from the eyelid nodule. Microscopic examination demonstrated acanthosis, hyperkeratos is, and papillomatosis (Fig. 3). Large dendritic cells with abundant melanin gra nules were spread throughout the epidermis. In addition, small basaloid or spino us keratinocytes were present in the malpighian layer.
文摘一个半综合征(The one and half syndrome)临床上少见,我科收治1例,经CT确诊为桥脑出血。报告如下: 患者女性、57岁、1991年11月排便后突然头晕,视物模糊,非喷射状呕吐胃内容物两次,家人扶上床后意识不清,尿失禁;4年前查体发现血压高,但未予治疗。查体:血压26/18kPa,呈浅昏迷,颈强直,心肺腹部正常;双眼球不在同一水平,右侧低于左侧2mm;双瞳孔缩小,右侧直径1mm,左侧1.2mm,对光反射迟钝;四肢肌张力增高,右侧著,右上肢肌力Ⅳ级,下肢Ⅲ级,右侧腱反射亢进,Babinski征(+),入院后经降颅压,注射、静点胞二磷胆碱、牛黄醒脑注射液等治疗,于第三天转为嗜睡,视物呈双影,头晕明显。再查见左侧眼球呈中央位,不能内收外展;右侧眼球除呈外层位外,内收时不能过中线。
