教学查房最终版.pptVIP

病例分析 case analysis 定位诊断 topical diagnosis （2)根据左手轮替运动轻微笨拙、头CT左小脑半球低密度灶，定位于左小脑半球受损slight unskilledly alternating movements of his left hand and large lower density area in his left cerebellar hemisphere showing by his head CT scan located at his left cerebellar hemisphere . 病例分析 case analysis 鉴别诊断 differential diagnosis （5）小脑肿瘤 cerebellar tumorH:\髓母1c.tif H:\髓母2a.tif （6）突发性耳聋 sudden hearing loss （7）体位性低血压（直立性低血压 ） postural hypotension Beijing Chaoyang Hospital 紧跟医院建设步伐 再创科室事业辉煌 病例分析 case analysis 病史特点： （1）中年男性，病前病中无发热 Middle-aged man,no fever （2）急性、动态起 It was an acute case。 （3）前庭性眩晕，失平衡伴轻微的植物神经症状vestibulo vertigo ，loss of equilibrium ，with autonomic nerve  病例分析case analysis 病史特点： （4）不伴耳蜗症状（耳鸣、耳聋） without symptom of cochlea(no tinnitus or deafness ) （5）不伴复视、黑矇、视野缺损 Without diplopia、amaurosis 、 defect of visual field （6）虽有头痛（三天后），但颅内高压症状不明显Eventhough he had headache after 3 days, symtomps of acute intracranial hypertension is not obvious. 病例分析 case analysis 病史特点： （7）有血管病的危险因素（高血压、血脂异常、 腹型肥胖、不良生活习惯）Risk of vessel disease（ hypertension 、 hyperlipemia 、 abdominal fat 、bad living habit ) （8）既往无类似病史，无耳疾史 No siminal medical history ,no disease history of ear 病例分析 case analysis 体征 physical sign ： （1）左视有轻微水平眼震 slight level nystagmus when he looks left （2）左手轮替运动轻微笨拙 Alternating movements of his left hand is slight unskilled. 病例分析 case analysis 影像 images： 头CT示左小脑半球大面积低密度灶 Head CT showed large low density area in his left cerebellar hemisphere . 病例分析 case analysis 定位诊断 topical diagnosis （1）根据症状性前庭性眩晕、失平衡定位于前庭小脑系统（损害） vestibulo vertigo ，loss of equilibrium located at vestibulo cerebellum(injury） 病例分析 case analysis 定性诊断 etiologic diagnosis