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患儿女,11岁。因头痛呕吐一月余,视力减退,走路不稳20余天入院。头痛呕吐无明显诱因且呕吐呈喷射状;双眼视物不清,CT 显示第四脑室高密度占位病变,幕上梗阻性脑积水。检查:神志清,精神差,暴发性失语,双侧眼底视乳头水肿,双眼视力为0.1,眼球水平粗大震颤;其余颅神经阴性;颈软,四肢肌力正常,肌张力编高,步态蹒跚,Romberg 征(+),生理反射正常。手术所见:脑压极高,两小脑半球重度凸出,肉红色肿瘤生长于小脑下蚓部,填塞枕大池;向前达四脑室前壁,填充整个扩大的四脑室,脑室壁完整,与肿瘤无粘连;肿瘤下方与延髓部分粘连,向
Children with children, 11 years old. More than a month due to headache and vomiting, vision loss, walking instability more than 20 days admitted to hospital. Headache vomiting no obvious incentive and vomiting were jet-like; eyes blurred, CT showed high-density space-occupying lesions of the fourth ventricle, supratentorial obstructive hydrocephalus. Check: Consciousness, poor spirits, aphasia, bilateral fundus papilledema, binocular visual acuity of 0.1, eye level coarse tremor; the rest of the cranial nerve-negative; neck soft, normal muscle strength, high muscle tension, gait hobbled , Romberg sign (+), normal physiological reflex. Surgical findings: high intracranial pressure, severe protrusion of the cerebellar hemispheres, flesh-red tumor growth in the cerebellar vermis, filling the pillow pool; forward up to the anterior wall of the fourth ventricle, filling the entire enlarged four ventricle, ventricular wall integrity, and tumor No adhesions; tumor below the medulla oblongata adhesions, to