Sugiura Tomohito, Torii Tsuyoshi
Department of Neurology, National Hospital Organization Kure Medical Center, 3-1 Aoyama, Kure city, Japan.
BMJ Case Rep. 2017 Dec 20;2017:bcr-2017-222535. doi: 10.1136/bcr-2017-222535.
A 55-year-old right-handed man with a history of hypertension suddenly fell and developed right hemiparesis. Neurological examination revealed that he was alert, but did not appropriately respond to verbal questions and commands. Detailed examination revealed that he could correctly respond to written commands. His speech was almost fluent, showing no paraphasia and normal articulation. His written sentences were legible. Pure tone audiometry showed that his auditory acuity was relatively preserved. His brainstem auditory evoked potential components from I to V were recorded bilaterally with normal latency. Cerebral CT demonstrated fresh bleeding in the left putamen and an old haemorrhage on the opposite side. He was treated by antihypertensive therapy and rehabilitation. Although there remained mild sensory deficit on his right extremities and he felt a slight noise during conversation, he had little difficulty with verbal communication when he was transferred to another hospital on day 38.
一名55岁的右利手男性，有高血压病史，突然跌倒并出现右侧偏瘫。神经系统检查发现他意识清醒，但对言语问题和指令反应不当。详细检查发现他能正确回应书面指令。他的言语几乎流利，无错语，发音正常。他写的句子清晰可读。纯音听力测试显示他的听力相对保留。双侧记录了他从I到V的脑干听觉诱发电位成分，潜伏期正常。脑部CT显示左侧壳核有新鲜出血，对侧有陈旧性出血。他接受了降压治疗和康复治疗。尽管他的右侧肢体仍有轻度感觉障碍，且在交谈时感到有轻微噪音，但在第38天转至另一家医院时，他在言语交流方面几乎没有困难。
