每日一题_2023.06.21

A 19-year-old college student is admitted to the hospital for bacterial meningitis. The patient initially recovers and responds to treatment. However, later in her hospital stay she begins to experience headache and blurred vision. Her physicians note cognitive decline and a gait disturbance that was not evident during her brief recovery phase. CT of the head shows enlarged ventricles. Which of the following mechanisms is most likely responsible for the patient’s deterioration?

一名19岁的大学生因细菌性脑膜炎住院。患者最初恢复并对治疗有反应。然而，在住院的后期，她开始出现头痛和视力模糊。医师注意到患者的认知功能下降和步态障碍，但在短暂的恢复期并不明显。头部CT显示脑室扩大。下列哪一种机制最有可能导致患者病情恶化?

(A) Destruction of brain parenchyma 脑实质破坏

(B) Excessive cerebrospinal fluid production 脑脊液产生过多

(C) Fusion of the cranial sutures 颅缝融合

(D) Impaired cerebrospinal fluid resorption 脑脊液吸收受损

(E) Obstruction of the cerebral aqueduct 脑导水管梗阻

答案解析：

蛛网膜颗粒是蛛网膜穿过硬脑膜进入上矢状窦的外生物。它们负责将脑脊液(CSF)中的液体回流到全身循环。继发于脑膜炎或蛛网膜下腔出血的脑膜刺激后，蛛网膜颗粒会形成疤痕，不能吸收足够的脑脊液。这导致脑脊液在蛛网膜下腔和脑室积聚，产生交通性脑积水。

正确答案：D