40岁男性，伴有头痛及精神状态改变。

40-year-old Male with a Headache and Altered Mental Status.

作者信息

Rubenstein Rebecca J, Alblaihed Leen, Dezman Zachary D W, Bontempo Laura J

机构信息

University of Maryland Medical Center, Department of Emergency Medicine, Baltimore, Maryland.

University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.

出版信息

Clin Pract Cases Emerg Med. 2020 Nov;4(4):499-504. doi: 10.5811/cpcem.2020.10.49546.

DOI:10.5811/cpcem.2020.10.49546

PMID:33217256

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7676804/

Abstract

A 40-year-old man presents to the emergency department with headache, nausea and paresthesias, with subsequent fever and mental status change. Magnetic resonance imaging showed increased fluid-attenuation inversion recovery signal involving multiple areas of the brain, including the pons. This case takes the reader through the differential diagnosis of rhombencephalitis (inflammation of the hindbrain) with discussion of the unanticipated ultimate diagnosis and its treatment.

摘要

一名40岁男性因头痛、恶心和感觉异常就诊于急诊科，随后出现发热和精神状态改变。磁共振成像显示脑桥等多个脑区的液体衰减反转恢复序列信号增强。本病例引导读者对菱脑炎（后脑炎症）进行鉴别诊断，并讨论意外的最终诊断及其治疗方法。