Hashimoto Y, Takano Y, Seto T, Watanabe S, Araki S
First Department of Internal Medicine, Kumamoto University Medical School.
Rinsho Shinkeigaku. 1991 Nov;31(11):1241-4.
We reported a case of bilateral cerebellar hemorrhagic infarction in the distribution of the bilateral superior cerebellar artery. A 58-year-old man suddenly developed dizziness and transient loss of consciousness. The neurological examination revealed left hearing disturbance, left sensory disturbance involving face, dysarthria and bilateral ataxia. This patient was considered to be classic clinical syndrome of right superior cerebellar artery. CT and MRI revealed hemorrhagic infarction corresponding to the full territory of the bilateral superior cerebellar artery. The right posterior cerebral artery was filling through the right posterior communicating artery on the right carotid angiography taken 2 hours after the onset. Bilateral vertebral angiography on the 18th day demonstrated no occlusions in the basilar artery and the bilateral superior cerebellar artery. Hemorrhagic infarction corresponding to the full territory of the bilateral superior cerebellar artery, sparing other territories as the present case, is extremely rare. In this case, cerebral embolism (top of the basilar syndrome) was suggested because of existence of atrial fibrillation and sudden onset.
我们报告了一例双侧小脑上动脉供血区的双侧小脑出血性梗死病例。一名58岁男性突然出现头晕和短暂意识丧失。神经系统检查发现左侧听力障碍、左侧面部感觉障碍、构音障碍和双侧共济失调。该患者被认为是右侧小脑上动脉的典型临床综合征。CT和MRI显示双侧小脑上动脉供血区全区域的出血性梗死。发病2小时后进行的右侧颈动脉血管造影显示,右侧大脑后动脉通过右侧后交通动脉供血。第18天的双侧椎动脉血管造影显示基底动脉和双侧小脑上动脉无闭塞。如本例所示,双侧小脑上动脉供血区全区域的出血性梗死,而其他区域未受累,极为罕见。由于存在心房颤动和突然起病,该病例提示为脑栓塞(基底动脉尖综合征)。