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案例男,43岁。1987年1月15日左下颌部被拳击,当即例地,急送医院。据病历记载:神志清楚,两侧瞳孔等圆,直径0.3cm,光反射灵敏;神经系统体征(一)。除枕部右侧有2×2cm头皮肿胀外,颅脑余无异常发现。伤后19天因出现颅内出血症状(其间无再次外伤史)收入院,检查发现左额叶内血肿;颈动脉造影见左大脑前动脉的胼周动脉末梢有一直径约0.3cm的动脉瘤。行血肿清除术及左胼周动脉瘤切除术,发现动脉瘤位于左额叶血肿右侧近矢状面大脑镰下,瘤体向外膨出,瘤囊壁不完整,囊内有血栓形成。镜检见瘤囊内有成片红细胞、白细胞,周围有血小板梁,少许胶原纤维及平滑肌纤维,未见明确血管壁。同年3月13日因脑干功能衰竭死亡。
Case male, 43 years old. January 15, 1987 left jaw was boxing, immediately, immediately sent to the hospital. According to the record: Consciousness, round pupil on both sides, diameter 0.3cm, sensitive to light reflexes; neurological signs (a). In addition to the right side of the occipital 2 × 2cm scalp swelling, no abnormal cranial brain found. 19 days after injury due to the occurrence of intracranial hemorrhage symptoms (during which there is no history of further trauma) admission to the hospital, check the left frontal lobe hematoma; carotid artery angiography seen in the left anterior cerebral artery peripheral corpus a diameter of about 0.3cm aneurysms. Hematoma removal and left corpus circumferential artery aneurysm resection and found that the aneurysm is located in the right side of the left frontal hematoma near the sagittal falx, the tumor outward bulging tumor wall incomplete, thrombosis within the capsule. Microscopic examination within the tumor capsule into a piece of red blood cells, white blood cells, platelets around the beam, a small amount of collagen fibers and smooth muscle fibers, no clear vessel wall. March 13 the same year died of brain stem failure.