医学英语学习7
Case7: Medial sphenoid wing meningioma 蝶骨嵴内侧脑膜瘤 A -year-old woman had suffered 岁女性，左侧头痛left-sided headache for 3 years. Shortly before 病史3年。入院前有hospitalization she experienced transient y spells 短暂的发作性意识丧with loss of consciousness. Two years earlier 失数次。2年以前出现she had had an episode of speech impairment 过一次短暂性言语功and paralysis of the right arm that resoved in a 能障碍和右上肢瘫few minutes. Results of neurological 痪，数分钟后自行缓examination were positive only for slight paresis 解。神经系统查体仅of the right arm. CT scan showed a mass lesion 见右上肢力量减弱。that appeared to arise from the left medial CT扫描可见左侧蝶sphenoid wing extending into the anterior and 骨嵴内侧一占位性病middle cranial fossa. The cerebral angiogram 变，向前中颅窝延伸。displayed upward deviation of the middle 造影显示大脑中动脉cerebral artery with displacement of the anterior 上抬，大脑前动脉移cerebral artery and vascular pattern typical of 位，以及典型的脑膜meningloma. 瘤血管影像。 The tumor was exposed through a left 采用额颞瓣开颅，充frontotemporal crani-otomy with a wide opening 分打开外侧裂，充分of the Sylvian fissure. The meningio-ma was 暴露肿瘤。用超声吸reduced in size with the ultrasonic aspirator? 引器清除部分肿瘤，and the heavily enmeshed middle cerebral 使肿瘤组织缩小。然artery was microsurgically freed of tumor. 后仔细游离被包绕的Additional tumor was removed along the 大脑中动脉。沿大脑courses of the middle cerebral artery, and the 中动脉切除剩余的肿internal carotid artery, also enveloped by tumor, 瘤，同时仔细剥离被was isolated. It was then possible to completely 包绕颈内动脉。然后remove the neoplasm along with its dural 尽可能切除与蝶骨小attachment on the inner sphenoid wing. The 翼处硬脑膜粘连的肿anterior cerebral artery and the slightly 瘤。大脑前动脉和轻displaced left optic nerve were anatomically and 微移位的左侧视神经functionally preserved. The wound was closed 解剖和功能保留。逐in standard fashion. The patient left the hospital 层关闭切口。18天后18 days after the surgery, neurologically intact. 患者出院，无神经功Postoperative CT scan showed total tumor 能缺失术后CT示肿removal. 瘤全切。 The major problem with a medial sphenoid 对于此型蝶骨嵴内侧wing meningioma of this type is its close 脑膜瘤，需要注意的proximity to important structures, such as the 是肿瘤临近重要结internal carotid artery and its branches, the optic 构，如颈内动脉及其nerve, the oculomotor nerve, and possibly the 分支，视神经，动眼other motor nerves of the eye. By following the 神经以及其他眼球运surgical strategy described above,we were able 动神经。遵循以上描to safely isolate the internal carotid artery, which 述的策略，我们能够was completely encased in tumor, along with 安全分离被完全包绕functionally important adjacent structures. 的颈内动脉及其临近的具有重要功能的结构。