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患者女,50岁,因头晕、恶心呕吐6 h入院。患者入院前6 h晨起后突发头晕,视物旋转,恶心,呕吐咖啡样胃内容物2次,非喷射性,同时出现言语不清,四肢无力。否认既往高血压病史。查体:BP 130/80 mmHg;神志清楚,构音障碍,声音嘶哑;右侧睑裂变小;右侧面部痛觉减退,双侧软腭上抬力弱,四肢肌力4级。双侧指鼻试验及跟-膝-胫试验欠稳准,以右侧为重。左侧偏身痛觉减退。头部CT示延髓出血。头颅MRI示:延髓出血,颅内血管MRA无异常。行脑血管DSA造影未见异常。予减
Female, 50 years old, hospitalized for 6 hours because of dizziness, nausea and vomiting. 6h before admission patients suddenly dizziness, morning sickness, depending on the material rotation, nausea, vomiting, coffee-like stomach contents 2 times, non-jet sex, at the same time there is speechless, limb weakness. Denied the history of previous hypertension. Physical examination: BP 130/80 mmHg; conscious, dysarthria, hoarseness; right palpebral fissure is small; right facial pain relief, bilateral soft palate lift weak, limb muscle strength 4. Both sides of the nose test and heel - knee - tibia test less accurate, to the right as the most important. Left partial body pain decreased. Head CT showed bulbar bleeding. Head MRI showed: medullary hemorrhage, intracranial MRA no abnormalities. Cerebral vascular DSA angiography no abnormalities. To reduce