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患者,男,15岁。左眼球逐渐突出3年,伴头痛、左眼视力下降1年。头部无明显外伤史。检查:发育、营养一般,神经系统未发现异常。左眼球突出,向下斜视,眼球向上活动受限,左眼视力0.4。头颅未触及明显包块,无压痛区。实验室检查均正常。头颅平片显示额骨左侧有-3.7×3.5×2.5 cm之骨破坏区,边缘呈分叶状,有硬化带环绕,病灶内无钙化及分隔。左眼眶向下扩大。头颅及眼眶CT扫描显示:左额底区及大脑突面有一边界清楚之高密度病灶,CT值66Hu,增强后CT值 84 Hu,大小3.2×2.3×6.0 cm,病灶侵犯眶顶板向眼眶内侵入,致眼球向下前内突出,诊断:左额底、眼眶内沟通性脑膜瘤。手术所见:切开左侧额
Patient, male, 15 years old. Left eye gradually prominent 3 years, with headache, left eye vision decreased by 1 year. Head no obvious history of trauma. Check: development, nutrition in general, the nervous system found no abnormalities. Left eye prominent, downward strabismus, upward eye movement limited, left eye vision 0.4. The skull did not touch the obvious mass, no tenderness area. Laboratory tests are normal. The cranium plain film showed a -3.7 × 3.5 × 2.5 cm bone destruction area on the left side of the frontal bone. The edge was lobulated and surrounded by a hardening zone without calcification and separation. Left orbit downward expansion. CT scans of the skull and orbit showed that the CT scan of the frontal lobe of the left hemisphere and the brain with a clearly defined high-density lesion had a CT value of 66 Hu, an enhanced CT value of 84 Hu and a size of 3.2 × 2.3 × 6.0 cm. Invasion of the orbital roof into the orbit , Caused by the eye down to the former prominent, diagnosis: left forehead, orbital communicating meningiomas. Surgical findings: cut the left forehead