Gomez J G, Kotler J A, Long J B
Division of Neurological Surgery, Holy Cross Hospital, Fort Lauderdale, USA.
J Fla Med Assoc. 1995 Mar;82(3):199-201.
Two thousand thirty-eight years later, in the setting of a similar care presentation, a physician would take a detailed history and perform a clinical and neurological examination. A preliminary diagnosis would be entertained and followed by electroencephalography and magnetic resonance of the brain with and without paramagnetic contrast for diagnostic confirmation. The proper medical or surgical treatment would then be instituted. A reconstruction of the clinical history of Julius Caesar (100-44 B.C.) has been attempted from available information from literature. Although a definite conclusion obviously cannot be made, a differential diagnosis provided with a tentative hypothesis is presented. The patient had late onset of seizures in the last two years of his life, headaches, personality changes. Upon reexamination of existing Julius Caesar iconography, busts, statues and minted coins no skull deformities have been noted. Identification of a skull deformity as described by Suetonius would have confirmed the suspicion of meningioma involving the convexity of the cerebral hemispheres. Meningioma or slow-growing supratentorial glioma may well have been responsible for this man's illness. Who knows how the course of history might have been changed... Probably not at all.
两千零三十八年之后，在类似的医疗情形下，医生会详细询问病史并进行临床和神经学检查。会先做出初步诊断，然后进行脑电图检查以及脑部磁共振成像（有无顺磁性造影剂）以确诊。接着会采取适当的药物或手术治疗。已尝试根据文献中的现有信息重构尤利乌斯·恺撒（公元前100年 - 公元前44年）的临床病史。尽管显然无法得出确切结论，但给出了一个带有初步假设的鉴别诊断。该患者在其生命的最后两年出现癫痫发作、头痛和性格改变。重新审视现有的尤利乌斯·恺撒的肖像、半身像、雕像和铸币后，未发现颅骨畸形。如苏埃托尼乌斯所描述的颅骨畸形的发现本可证实对累及大脑半球凸面的脑膜瘤的怀疑。脑膜瘤或生长缓慢的幕上胶质瘤很可能是导致此人患病的原因。谁知道历史的进程会如何改变呢……或许根本不会改变。
