TY - T1的临床推理:一个33岁的女人有严重产后枕头痛JF -神经学乔-神经病学SP - 366 LP - 369 - 10.1212 / WNL。首页0 b013e31824528f8六世- 78 - 5 AU -南希Maalouf盟萨米i Harik Y1 - 2012/01/31 UR - //www.ez-admanager.com/cont首页ent/78/5/366.abstract N2 -一个33岁的女人,偶尔的历史“偏头痛”抱怨严重枕头痛,后一个简单的足月的硬膜外麻醉下经阴道分娩。这种头痛是定性和定量不同于她以往的头痛。低颅内压头痛的诊断与无意的硬脑膜穿刺被认为是和2硬膜外自体血补丁进行没有救援。产后一周她呈现给外部医院投诉的浓度差,很难找到的话,穿衣服,喂自己,左臂麻木。检查显示血压179/119毫米汞柱,可怜的注意力,失用症,降低感觉的左手。一般体格检查是模糊的。头部MRI(天0)显示fluid-attenuated反转恢复(天赋)hyperintensities(图1中,A和B)和扩散限制和积极的表观扩散系数(ADC)图(图1中,C和D)在右顶叶和胼胝体压部。后部可逆性脑病综合征的诊断(总统)是娱乐和病人治疗与抗高血压药物硝苯地平和赖诺普利条件。病人的病情恶化。 On the third hospital day, she became cortically blind and mute, and had motor perseverations and left-sided weakness. Repeat head MRI showed marked worsening with lesions involving the cortex and subcortical white matter of the parietal, posterior frontal, and occipital lobes, bilaterally (figure 1, bottom panel). Figure 1 Head MRI axial cuts: Fluid-attenuated inversion recovery (FLAIR) (A, B, E, F) and apparent diffusion coefficient map (C, D, G, H) sequences Upper panel MRI, performed on admission, showed FLAIR hyperintensities and diffusion restriction in the right parietal lobe and in the splenium of the corpus callosum (arrows). Lower panel, done on hospital day 3 when the patient deteriorated, showed worsening lesions involving the cortex and subcortical white matter of the parietal, posterior frontal, and occipital lobes, bilaterally (arrows). Question for consideration: What is the differential diagnosis? The differential diagnosis of multifocal infarcts in … ER -