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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Third Nerve Palsy: Harbinger of Basilar Artery Thrombosis and Locked-in Syndrome?
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Third Nerve Palsy: Harbinger of Basilar Artery Thrombosis and Locked-in Syndrome?

机译：第三神经性麻痹：基底动脉血栓形成和锁定综合征的预兆？

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We report a 45-year-old man who presented to Accident and Emergency with painless diplopia. He had a history of alcohol-dependency syndrome, noninsulin-de-pendent diabetes mellitus, hypertension, and lone atrial fibrillation, and he was a smoker of 20 cigarettes per day. He was taking aspirin (300 mg daily).He was in atrial fibrillation but general physical examination was otherwise normal. Neurologic examination revealed the left eye to be in a downward and abducted position with left ptosis. Both pupils were 2 mm in size and equally reactive to light and accommodation. The right eye was normal. There was no other neurologic deficit. He was diagnosed with a left-sided third nerve palsy and was admitted to hospital. Computed tomography, magnetic resonance imaging, and diffusion weighted imaging of the brain was normal. Magnetic resonance angiogram revealed congenital atresia of the right vertebral artery. He was discharged home on aspirin and pravastatin (20 mg daily).He presented again 3 weeks later with left-sided weakness. Examination showed normal cranial nerve function but he had a dense left hemlparesis.
机译：我们报告了一名45岁的男子，他因无痛性复视而出现在事故和紧急情况下。他有酒精依赖综合征，非胰岛素依赖型糖尿病，高血压和孤独性心房颤动的病史，并且每天吸烟20支烟。他正在服用阿司匹林（每天300毫克），正在房颤中，但其他常规体检正常。神经系统检查显示左眼处于向下并被外展的位置，伴有上睑下垂。两个瞳孔均为2毫米大小，对光线和适应性的反应均等。右眼正常。没有其他神经系统缺陷。他被诊断出患有左侧第三神经麻痹并入院。脑部计算机断层扫描，磁共振成像和弥散加权成像正常。磁共振血管造影显示右椎动脉先天性闭锁。他出院后服用阿司匹林和普伐他汀（每天20 mg）出院回家。3周后他再次出现左侧无力。体检显示颅神经功能正常，但左血肿偏密。

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