成人髓母细胞瘤罕见病例中的库欣反射。
Cushing's reflex in a rare case of adult medulloblastoma.
机构信息
Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, FL 33140, USA.
出版信息
World J Emerg Med. 2014;5(2):148-50. doi: 10.5847/wjem.j.issn.1920-8642.2014.02.013.
BACKGROUND
Medulloblastoma is a primitive neuro-ectodermal tumor. It is common in childhood, but rarely seen at adult age, comprising only 1% of primary brain tumors.
METHODS
We treated a 31-year-old man presented to the emergency department (ED) with a chief complaint of nausea and vomiting for one week duration. Immediate frozen section revealed a grade IV medulloblastoma. During the hospital course, the patient was given craniospinal irradiation with chemotherapy.
RESULTS
The patient was eventually discharged from the hospital to an assisted living facility after an uneventful 15-day course with the aid of social work.
CONCLUSIONS
Despite intracranial tumors generally being slow growing masses, this patient demonstrates how quickly one can decompensate, and how important it is to recognize these clinical signs and symptoms of an intracranial lesion. Although these symptoms (i.e. Cushing response) are extremely rare, the ED physician should be aware and appreciate their clinical significance.
背景
髓母细胞瘤是一种原始神经外胚层肿瘤。它常见于儿童，但在成年期很少见，仅占原发性脑肿瘤的 1%。
方法
我们治疗了一名 31 岁男性，他因恶心和呕吐一周来到急诊科就诊。立即进行的冷冻切片显示为 4 级髓母细胞瘤。在住院期间，患者接受了颅脊髓照射化疗。
结果
患者在经历了 15 天无并发症的治疗后，在社会工作者的帮助下出院到辅助生活设施。
结论
尽管颅内肿瘤通常是生长缓慢的肿块，但该患者表明颅内病变的临床症状和体征可能会迅速恶化，因此认识到这些症状和体征非常重要。虽然这些症状（即库欣反应）极其罕见，但急诊医生应该意识到并重视其临床意义。
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