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患者男,54岁。因右侧肢体不能活动,意识不清3~+小时入院。入院前3~+小时在外面吃早饭时突然意识不清,随之歪倒在地,双眼向左注视,不能言语。半小时后做头颅CT检查。发病3~+小时收入院。48小时后复查头颅CT,既往高血压史17年。查体:血压18/12kPa,脉搏72次/分。中年男性,嗜睡状态,完全性运动性失语,颈软,左侧颈动脉搏动消失。心率72次/分,律规整,未闻及杂音。双跟向左侧凝视,左Horner征,右侧鼻唇沟浅,伸舌时,舌不自主向各方向运动,以致使其不能维持一定舌位。右侧肢体肌张力增高,腱反射消失,肌力0～Ⅰ级。左侧肌张力低,肌力Ⅴ级,左侧肢体时有不自主舞动左侧上肢、手指、腕、前臂不自主,无规则伸屈,翻转,舞动。下肢趾,躁部不自主伸展屈曲,偶有呶嘴动作。右Bahonski(+),双Kerning(-),辅助检查:血糖8.6mmol/L,血色素141g/L,白血球12×10~9/L,中性
Male patient, 54 years old. Due to the right limb can not move, unconsciousness 3 ~ + hours admitted. 3 ~ + hours before admission to eat breakfast suddenly out of consciousness, then crooked to the ground, his eyes to the left, can not speak. Half an hour after head CT examination. Incidence 3 ~ + hours income hospital. After 48 hours review skull CT, previous history of hypertension for 17 years. Physical examination: blood pressure 18 / 12kPa, pulse 72 beats / min. Middle-aged men, drowsiness, complete exercise aphasia, neck soft, left carotid pulse disappeared. Heart rate 72 beats / min, law and order, no smell and noise. Double to the left side of the gaze, left Horner sign, the right nasolabial fold shallow, extending the tongue, the tongue involuntarily move in all directions, so that it can not maintain a certain tongue position. The right limb muscle tension increased, tendon reflex disappeared, muscle strength 0 ~ Ⅰ level. Low left muscle tension, muscle strength grade Ⅴ, involuntary movements on the left limb when the left upper limbs, fingers, wrists, forearm involuntary, non-regular flexion and extension, flip, dance. Lower extremity toe, impatient involuntary flexing, pouting occasionally action. Right Bahonski (+), double Kerning (-), Assisted examination: glucose 8.6 mmol / L, hemoglobin 141 g / L, white blood cells 12 x 10-9 / L, neutral