A 74-year-old man presented with a 2-year history of gait ataxia, bilateral sensorineural hearing loss, cognitive impairment, vertigo, falls and urinary retention. His mobility had worsened, with several falls over 3 months. Two and half years before, he had been thrown from his quad bike while 3 000 feet up a mountain, hitting his head without a helmet. He had also sustained multiple mild traumatic brain injuries in childhood and adolescence due to fights, horseback riding and skiing. On neurological examination, there was bilateral deafness, left pronator drift and mild weakness throughout all four limbs (4/5 MRC). Deep tendon reflexes were symmetric and brisk throughout (3+) and cerebellar testing showed left upper arm dysmetria. MR scan of brain with susceptibility-weighted imaging (figure 1A) and T2-weighted imaging (figure 1B) showed superficial siderosis involving the Sylvian fissures, brainstem structures, cerebellar sulci and surrounding the third and lateral ventricles. MR …

中文翻译：

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硬脑膜撕裂修复和去铁酮治疗浅表铁质沉着症


一名 74 岁男性，有 2 年步态共济失调、双侧感音神经性听力损失、认知障碍、眩晕、跌倒和尿潴留病史。他的活动能力恶化，3个月内多次跌倒。两年半前，他在 3000 英尺高的山上从四轮摩托车上摔下来，没戴头盔就撞到了头部。他在童年和青少年时期还因打架、骑马和滑雪而遭受多处轻度创伤性脑损伤。神经系统检查显示双侧耳聋、左旋前肌漂移和四肢轻度无力（4/5 MRC）。深部腱反射自始至终都是对称且活跃的（3+），小脑测试显示左上臂辨距困难。磁化率加权成像（图 1A）和 T2 加权成像（图 1B）对大脑进行 MR 扫描显示，浅表铁沉积涉及侧裂、脑干结构、小脑沟以及第三脑室和侧脑室周围。先生 …