神經(jīng)外科英語病例

1、case 1: brain trauma: epidural hematoma腦外傷：硬膜外血腫case 2: brain trauma: epidural hematoma腦外傷：硬膜外血腫case 3: brain trauma: chronic subdural hematoma腦外傷：慢性硬膜下血腫case 4: posterior fossa subdural hematoma (pfsdh) in neonate新生兒后顱窩硬膜下血腫case 5: astrocytoma of frontal lobe額葉星形細(xì)胞瘤case 6: glioblastoma multiforme o

2、f frontal lobe額葉多形膠母細(xì)胞瘤case 7: glioblastoma multiforme located near motor cortex運(yùn)動(dòng)區(qū)附近的多形膠母細(xì)胞瘤case 8: choroid plexus papilloma of third ventricle (transcallosal approach)三腦室脈絡(luò)叢乳頭狀瘤（經(jīng)胼胝體入路）case 9: hypothalamic glioma丘腦下部膠質(zhì)瘤case 10:chiasmal glioma視交叉膠質(zhì)瘤case 11: meningioma of the anterior skull base前顱底腦

3、膜瘤case 12 : olfactory groove meningioma嗅溝腦膜瘤case 13: lateral sphenoid wing meningioma蝶骨嵴外側(cè)腦膜瘤case 14: medial sphenoid wing meningioma蝶骨嵴內(nèi)側(cè)腦膜瘤case 15: sphenocavernous meningioma蝶骨嵴海綿竇腦膜瘤case 16: recurrent meningioma involving the cavernous sinus海綿竇復(fù)發(fā)性腦膜瘤case 17: suprasellar meningioma鞍上腦膜瘤case 18: tu

4、berculum sellae-planum sphe noidale meningioma鞍結(jié)節(jié)蝶骨平臺(tái)腦膜瘤case 19: meningioma of the left optic sheath左視神經(jīng)鞘腦膜瘤case 20: clivus meningioma斜坡腦膜瘤case 21: a recurrent inferior clival menin gioma (with far lateral approach)復(fù)發(fā)性斜坡下段腦膜瘤（遠(yuǎn)外側(cè)入路）case 22: petroclival meningioma巖斜腦膜瘤case 23: petroclival middle foss

5、a meningioma巖斜中顱窩腦膜瘤case 24 trigeminal meningioma三叉神經(jīng)腦膜瘤case 25 : cerebellopontine angle meningioma (located anterior to the iam)小腦橋腦角腦膜瘤（內(nèi)聽道前）case 26:cerebellopontine angle meningioma (located posterior to the iam)小腦橋腦角腦膜瘤（內(nèi)聽道后）case 27: incisural meningioma小腦幕切跡腦膜瘤case 28: jugular foramen meningiom

6、a頸靜脈孔區(qū)腦膜瘤case 2 9 : craniospinal meningioma顱頸交界部腦膜瘤30: meningioma (c2-3)脊膜瘤（頸）case 31: pituitary adenoma (chromophobe type)垂體瘤（嫌色性）case 32: pituitary macroadenoma in acro-megaly垂體大腺瘤伴肢端肥大癥case 33: pituitary macroadenoma in aero megaly垂體大腺瘤伴肢端肥大癥case 34: recurrence of an extensive para-and suprasella

7、r pituitary adenoma復(fù)發(fā)性鞍旁鞍上垂體瘤case 3 5: pituitary adenoma (complicated by postoperative ccf)垂體瘤（術(shù)后并發(fā)頸動(dòng)脈海綿竇瘺）case 36: pituitary chromophobe adenoma (oculomotor nerve repair usinginterposed nerve graft)垂體嫌色細(xì)胞腺瘤（用神經(jīng)移植修復(fù)動(dòng)眼神經(jīng)）case 37: large pituitary adenoma with very extensive intracranial growth垂體大腺瘤伴廣泛

8、顱內(nèi)生長case 38: entirely suprasellar symptomatic rathkcts cleft cyst鞍上癥狀性rathke裂囊腫case 39: intraventricular craniopharyngi oma內(nèi)顱咽管瘤腦室case 40: craniopharyngioma with invasion of the third ventricle and obstructive hydrocephalus顱咽管瘤侵入第三腦室伴埂阻性腦積水case 41: craniopharyngioma ( spontaneous reduction)顱咽管瘤（自發(fā)消退

9、）case 42: trigeminal neurinoma三叉神經(jīng)瘤case 43 - trigeminal neurinoma三叉神經(jīng)瘤case 44; neurofibroma of the infratemporal fossa 顳下窩神經(jīng)纖維瘤case 45: neurinoma of the abducens nerve外展神經(jīng)瘤case 46: schwannoma in the petrous bone 巖骨內(nèi)神經(jīng)鞘瘤case 47: glossopharyngeal schwannoma舌咽神經(jīng)鞘瘤case 48: neurinoma of the jugular foram

10、en頸靜脈孔區(qū)神經(jīng)瘤case 49: neurinoma of the jugular foramen頸靜脈孔區(qū)神經(jīng)瘤case 50: schwannoma located anterior to cervicomedullary junction延頸髓交界處前方神經(jīng)鞘瘤case 51: epidermoid tumor of the cerebel lopontine angle小腦橋腦角表皮樣腫瘤case 52: epidermoid tumor of the lateral wall of the cavernous sinus海綿竇側(cè)壁表皮樣腫瘤case 53: cerebellopo

11、ntine angle lipoma小腦橋腦角脂肪瘤case 5 4: intracranial germ cell tumor顱內(nèi)生殖細(xì)胞瘤case 55: papillary adenoma of endolym phatic sac origin源自內(nèi)淋巴囊的乳頭狀腺瘤case 56: esthesioneuroblastoma of nasal cavity and adjacent paranasal sinuses鼻腔和鼻旁竇感覺神經(jīng)母細(xì)胞瘤case 57: angiofibroma of paranasal sinu ses, nasopharynx and skull base

12、鼻旁竇、鼻咽和顱底血管纖維瘤case 58: intrinsic brainstem tumor (glioma)腦干腫瘤（膠質(zhì)瘤）case 59: brain stem tumor (astrocytoma)腦干腫瘤（星形細(xì)胞瘤）case 60: brainstem tumor (hemangioblas toma)腦干腫瘤（血管母細(xì)胞瘤）i 120 typical cases of neurosurgerycase 1: brain trauma: epidural hematoma腦外傷：硬膜外血腫a 65-year-old right-handed man was transferre

13、d to the hospital approximately 16 hours after suffering head trauma with loss of consciousness in a motor-vehicle accident.examination. general examination was remarkable for a left parietal scalp laceration, left hemotympanum, and right periorbital hematoma眶周血腫. funduscopic examination 眼底檢查was wit

14、hin normal limits. neurological examination revealed an alert patient oriented to time and person but not to place. a mixed aphasia was present with expressive and conductive elements. sensory examination was normal. there was left-sided weakness; however; the patient did have a positive babinski si

15、gn on the left. the remainder of the neurological examination was normal. skull films revealed a left parietal linear skull fracture.course. the patient was admitted to the hospital for observation, and over the next 24 hours had modest but definite improvement in his aphasia. a ct scan was obtained

16、 approximately 24 hours after injury, and this reveals a left epidural hematoma with a 3-mm shift of midline structures from left to right, and effacement of the left lateral ventricle. because the patient had been improving neurologically, surgery was withheld pendingpending  pending簡明英漢詞

17、典pendiprep. 直到, 在等待期間adj. 1 未決的, 未定的, 待定的 2 即將發(fā)生的 詞條指正 - google 搜索 any evidence of neurological deterioration. by the 2nd day, the patient had complete resolution of his aphasia except for a very mild dysnomic component. follow-up ct scan on the 4th hospital d

18、ay demonstrated no significant change from the performed 24 hours after admission. the patient continued to improve and was discharged asymptomatic following complete resolution of his neurological deficits and headaches on the 6th hospital day. repeat ct scans were obtained on the 17th and 30th pos

19、tinjury day. these showed gradual but complete resolution of the epidural hematoma.case 2: brain trauma: epidural hematoma腦外傷：硬膜外血腫a 21-year-old man was transferred to the hospital 3 days after suffering a closed-head injury with loss of consciousness. on admission, the patient was complaining of se

20、vere right-sided headaches.examination. the general examination demonstrated a right parietal laceration. neurological examination showed a mild abnormality of recent memory， but was otherwise within normal limits. plain films demonstrated a linear right temporal-parietal skull fracture.course. the

21、patient underwent ct scan on the day of admission. this revealed a right temporal-parietal epidural hematoma associated with a 4-to 4. 5-mm shift from right to left. because the patient demonstrated no neurological deficit, he was treated nonoperatively. during the hospital course, the patient had s

22、teady and complete resolution of his headache. repeat ct scan, 1 week after admission, demonstrated persistent right epidural hematoma, with less shift than noted previously. the patient was discharged without neurological deficit, a third scan, repeated 7 weeks after injury, demonstrated complete r

23、esolution of the epidural hematoma.case 3: brain trauma: chronic subdural hematoma腦外傷：慢性硬膜下血腫you are asked to see a 27-year-old woman, a successful corporate lawyer, because of increasing headaches which began approximately 1 month ago. she first noted headache several days after returning from a sk

24、i trip with her husband and two children. the headaches are bifrontal, throbbing, and increasing in severity. during the past week she has awaked from sleep on several occasions with headache and vomiting. in addition, her husband describes her as more apathetic and less "sharp" at work th

25、an usual. one week ago she saw a local physician who prescribed valium. there have been no visual, motor, or sensory complaints. she is not on any medications, has no other medical illnesses, and has suffered no recent trauma. on examination , she was tearful and complained of severe steady headache

26、 and an inability to sleep for several days. she relied on her husband for most of the details of her illness. on several occasions, she did not respond to questions asked directly to her and the questions had to be repeated. there was no aphasia, but detailed mental status testing was impossible be

27、cause of her agitated state.examination of the optic fundi revealed an absence of venous pulsations and blurring of the disc margins. the remainder of the cranial nerve examination was normal. there was a mild pronator drift of the right arm but power was otherwise normal. there was reflex asymmetry

28、 (3/5 on the right, 2/5 on the left) and plantar responses were flexor on the left and equivocal on the right. tone, sensory, and cerebellar examinations were within normal limits, and her gait was normal. a ct scan was performed.the scan shows a large, left-sided, isodense? chronic subdural hematom

29、a. on the nonenhanced scan, the subdural hematoma itself was not visible because of its isodense character, but a shift of the lateral ventricles due to mass effect was seen. with contrast enhancement 9 the membranous wall of the subdural hematoma can be seen and the size of the subdural collection

30、is clearly outlined.the treatment for symptomatic, chronic subdural hematomas is surgical evacuation. in patients with small, stable subdural hematomas, or in those for whom surgery is contraindicated, medical management with corticosteroids and dehydrating agents(mannitol) may be successful. in thi

31、s patient surgical evacuation was performed with excellent results.case 4: posterior fossa subdural hematoma (pfsdh) in neonate新生兒后顱窩硬膜下血腫this newborn female was born at a gestational age of 40 weeks,weighing 3780g, to a gravida 2 para 1 mother. forceps were applied to the fetal head for failure to

32、progress. apgar scores were 6 and 9. within the 1st day of life, the baby was observed to be listless and lethargic and to have a poor suck. the anterior fontanelle was tense. seizures developed. endotrachealintubation and ventilation were required for bradycardia and apneic episodes. the hemogram w

33、as normal. a lumbar puncture was performed to rule out central nervous system sepsis, and bloody cerebrospinal fluid(csf) was obtained. ct was then performed， and a large pfsdh was observed in addition to moderate ventriculomegaly. a neurosurgical consultation was obtained. the neonate was quadriple

34、gic on a ventilator, making only the occasional respiratory effort.the neonate was taken urgently to surgery, and a posterior fossa craniectomy was performed. the clot could be removed from the posterior fossa subdural space. the bleeding sites were identified and successfully coagulated. the infant

35、 did not require an external ventricular drain nor did she go on to develop progressive hydrocephalus. she began to breathe readily after the posterior fossa decompression and clot evacuation. she was weaned from the ventilator within 4 days. subsequent ct showed minimal left cerebellar parenchymal

36、involvement with calcification and volume loss. the ventriculomegaly had resolved completely. at 4 years of age, the child walked and talked normally. a right esotropia remained that had persisted since surgery.case 5: astrocytoma of frontal lobe額葉星形細(xì)胞瘤the patient was a 48-year-old male who presente

37、d with complaints of increasingly severe headaches. workup at another hospital revealed a lucent left frontal lesion. the biopsy diagnosis was grade iii astrocytoma. he was referred to our hospital after external radiation therapy was delivered. neurological exam revealed mild bradykinesia, but was

38、otherwise unremarkable. he was admitted and underwent a left frontal lobectomy , with gross total tumor resection. one month later he underwent stereotactic implantation of brachytherapy catheters. he received 6000 rads to the margins of the tumor cavity. subsequent scans revealed progressively wors

39、ening enhancement, edema? and shift around the tumor cavity. reoperation was undertaken with resection of all grossly abnormal tissue. pathologic analysis revealed radiation necrosis and tumor. the patient is alive 5 years later, with no evidence of disease progression.case 6: glioblastoma multiform

40、e of frontal lobe額葉多形膠母細(xì)胞瘤a healthy 6-year-old woman presented with a 3-month history of dysphasia. computed tomography demonstrated a ring-enhancing lesion in the right frontal lobe. she was not immune-suppressed or on steroids. the rim was t2 hypointense and tl hyperintense. there was a small amou

41、nt of surrounding edema. brain abscess was considered in the differential diagnosis? but a tumor was believed more likely, because; (1) there was an eccentric area of capsular thickening (2) edema was minimal, and (3) the clinical course was long. at operation, glioblastoma multiforme was encountere

42、d. substances with unpaired electrons exhibit an unusual combination of increased tl signal and decreased t2 signal termed paramagnetism. methemoglobin, melanin, and gadolinium are familiar paramagnetic substances. in an abscess capsule, paramagnetic changes occur because macrophages release free-ra

43、dicals that contain unpaired electrons. although uncommon, clinicians should be aware that paramagnetic rim signal may also be observed in metastasis, primary brain tumors, gran-ulomas like tuberculosis, and in large demyelinating plaques.case 7: glioblastoma multiforme located near motor cortex運(yùn)動(dòng)區(qū)附

44、近的多形膠母細(xì)胞瘤historypatient a. l. is a 23-year-old right handed man from hebei who works as a painter and has had nocturnal seizures for approximately two years. in january the seizures increased in frequency and began to occur during the day. they are associated with turning of the head and shoulders t

45、o the right prior to generalization. the patient is confused and fatigued afterwards, but does not have a neurologic deficit. a scan was done in february and this demonstrates an area of nonenhancement in the posterior portion of the superior frontal convolution, with a small contrast enhancing area

46、 in the center of the lesion. the latter approximately 3 mm, the former measures approximately 3. 5 cm. the scan was repeated recently and it appeared that the lesion had grown slightly. stereotactic biopsy was recommended. the parent in fact was scheduled for a biopsy in hebei but they decided to s

47、eek another opinion. the patient is presently on dtlantin 100 mg three times per day. past medical history is noncontributory, family history and social history are not significant.physical examinationthe patient is a well nourished, well developed, thin, pleasant male who appears intellectually int

48、act. recent memory is intact? general information is good.cranial nerve examination reveals no abnormalities, sensory examination is intact to all modalities. motor examination reveals no drift to distraction, and good strength in upper and lower extremities. there may be some weakness of the wrist

49、extensors on the right, however. deep tendon reflexes are symmetrical, the patient walks with a normal gait with a normal arm swing.radiographic studiesmri scan shows an approximately 3. 5 cm well-demarcated lesion in the posterior aspect of the left superior frontal convolution.impressionprobable l

50、ow/intermediate grade glioma, possibly ganglio-glioma or ganglio-neurocytoma. if the lesion is anterior to the motor cortex, resection is recommended. if the lesion is within the motor cortex? a biopsy is recommended,hospital coursethe patient underwent magnetoencephalography (meg)to map his primary

51、 motor cortex and define its relationship to the tumor. this confirmed the clinical and radiographic impression that the tumor was anterior to the motor strip.a stereotactic volumetric resection of the lesion was then performed. the volume of the tumor, based on the contrast-enhancing portions on bo

52、th ct and mri, as well as from the area of abnormality on t2-weighted mri, was digitized for computer targeting. a view of the cortical surface after the trephine craniotomy was performed.a strip electrode placed onto the cortical surface in a direction posterior to the edge of the trephine confirme

53、d the location of sensorimotor cortex by phase reversal.the tumor volume can be superimposed onto the field of view of the operating microscope,to assist the surgeon in defining the margins of the tumor. the lesion was dissected away from the surrounding brain tissue at its interface and was removed

54、 as a single specimen. ,the patient's neurologic function postoperatively was unchanged from his preoperative status.pathologic reportthe tumor was signed out as glioblastoma multiforme arising as a small focus within a lowgrade astrocytoma. the malignant portion apparently was the contrast-enha

55、ncing portion on the preoperative scans. the patient is scheduled to begin external beam radiotherapy followed by chemotherapy.case 8: choroid plexus papilloma of third ventricle (transcallosal approach)三腦室脈絡(luò)叢乳頭狀瘤（經(jīng)胼胝體入路）this 8-year-old boy presented in may 1977 with a 3-week history of episodic hea

56、dache accompanied by vomiting and obtun-dation. hyperactive behavior and some difficulties with visual perception and motor coordination had been noticed from the age 1 or 3 years. examination by a pedtatrician 2 years earlier had revealed clumsy, slow, and deliberate walking and finger-to-nose d ra

57、pid alternating movements that were abnormally slow, with noticeable overflow movements to the opposite side. the patient's verbal intelligence quotient (i. q. ) had been recorded as 112 and his performance i. q. had been recorded as 74 (full scale, 92). more recently his performance in athletic

58、s had been above average? e. g. 9 he was considered to be the best pitcher in his baseball league.physical examination revealed mild papilledema and paralysis of conjugate upward gaze. a ct scan showed very large lateral ventricles and a calcified mass within the 3rd ventricle. a biven-triculo-peritoneal shunt was inserted. metrizamide ventriculogra-phy demonstrated a papillary mass within the 3rd ventricle and extruding through the right fora