翻译的神经外科医学英语学习1.doc

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1、医学英语学习7Case7:MedialsphenoidwingmeningiomaA64-year-oldwomanhadsufferedleft-sidedheadachefor3years.Shortlybeforehospitalizationsheexperiencedtransientyspellswithlossofconsciousness.Twoyearsearliershehadhadanepisodeofspeechimpairmentandparalysisoftherightarmthatre

2、sovedinafewminutes.Resultsofneurologicalexaminationwerepositiveonlyforslightparesisoftherightarm.CTscanshowedamasslesionthatappearedtoarisefromtheleftmedialsphenoidwingextendingintotheanteriorandmiddlecranialfossa.Thecerebralangiogramdisplayedupwarddeviationoft

3、hemiddlecerebralarterywithdisplacementoftheanteriorcerebralarteryandvascularpatterntypicalofmeningloma.Thetumorwasexposedthroughaleftfrontotemporalcrani-otomywithawideopeningoftheSylvianfissure.Themeningio-mawasreducedinsizewiththeultrasonicaspirator?蝶骨嵴内侧脑膜瘤64

4、岁女性，左侧头痛病史3年。入院前有短暂的发作性意识丧失数次。2年以前出现过一次短暂性言语功能障碍和右上肢瘫痪，数分钟后自行缓解。神经系统查体仅见右上肢力量减弱。CT扫描可见左侧蝶骨嵴内侧一占位性病变，向前中颅窝延伸。造影显示大脑中动脉上抬，大脑前动脉移位，以及典型的脑膜瘤血管影像。采用额颞瓣开颅，充分打开外侧裂，充分暴露肿瘤。andtheheavilyenmeshedmiddlecerebralarterywasmicrosurgicallyfreedoftumor.Additionaltumorwasremoved

5、alongthecoursesofthemiddlecerebralartery,andtheinternalcarotidartery,alsoenvelopedbytumor,wasisolated.Itwasthenpossibletocompletelyremovetheneoplasmalongwithitsduralattachmentontheinnersphenoidwing.Theanteriorcerebralarteryandtheslightlydisplacedleftopticnervew

6、ereanatomicallyandfunctionallypreserved.Thewoundwasclosedinstandardfashion.Thepatientleftthehospital18daysafterthesurgery,neurologicallyintact.PostoperativeCTscanshowedtotaltumorremoval.Themajorproblemwithamedialsphenoidwingmeningiomaofthistypeisitscloseproximi

7、tytoimportantstructures,suchastheinternalcarotidarteryanditsbranches,theopticnerve,theoculomotornerve,andpossiblytheothermotornervesoftheeye.Byfollowingthesurgicalstrategydescribedabove,wewereable用超声吸引器清除部分肿瘤，使肿瘤组织缩小。然后仔细游离被包绕的大脑中动脉。沿大脑中动脉切除剩余的肿瘤，同时仔细剥离被包绕颈内动脉。

8、然后尽可能切除与蝶骨小翼处硬脑膜粘连的肿瘤。大脑前动脉和轻微移位的左侧视神经解剖和功能保留。逐层关闭切口。18天后患者出院，无神经功能缺失术后CT示肿瘤全切。对于此型蝶骨嵴内侧脑膜瘤，需要注意的是肿瘤临近重要结构，如颈内动脉及其分支，视神经，动眼神经以及其他眼球运动神经。tosafelyisolatetheinternalcarotidarte