病例355

文献信息

中文摘要

一名8岁女孩因头痛就诊于儿科医生，头痛已持续2-3年，但在过去8天内变得难以忍受。患者描述头痛无侧别偏向，主要累及额部和枕部区域。患者将头痛疼痛程度评为十分之八，导致她无法入睡。镇痛治疗被证明无效。患者无畏光或畏声，但疲劳加重，并出现恶心但无呕吐。患者无吞咽困难、共济失调、眩晕或言语问题。此前在一家省级医院进行的MRI显示后颅窝有一肿块，压迫脑干。然而，由于无法及时预约神经外科医生，患者因症状加重而到我院急诊科就诊。为排除症状的颅内起源，进行了脑部增强MRI（图）。

英文摘要

An 8-year-old girl presented to the pediatrician with headaches that she had been experiencing for the last 2-3 years but that had become intolerable in the previous 8 days. The headaches were described by the patient as not having any lateralization and mainly involving the frontal and occipital regions. The headaches were rated by the patient as being an eight out of 10 in terms of pain, which prevented her from sleeping. Analgesic therapy proved to be ineffective. The patient had no photophobia or phonophobia but had increased fatigue alongside developing nausea without vomiting. The patient did not have any dysphagia, ataxia, vertigo, or elocution issues. Previous MRI performed in a provincial hospital showed a mass in the posterior fossa that was displacing the brainstem. However, being unable to get an appointment to see a neurosurgeon in a timely manner, the patient presented to the emergency department of our university hospital due to worsening symptoms. In order to exclude an intracranial origin of the symptoms, brain MRI with contrast enhancement was performed (Figure).