鉴别良性阵发性位置性眩晕与旋转性椎基底动脉缺血的策略。

Strategies to distinguish benign paroxysmal positional vertigo from rotational vertebrobasilar ischemia.

作者信息

Heidenreich Katherine D, Carender Wendy J, Heidenreich Michael J, Telian Steven A

机构信息

Division of Otology and Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, MI 48109-5312, USA.

出版信息

Ann Vasc Surg. 2010 May;24(4):553.e1-5. doi: 10.1016/j.avsg.2009.09.018. Epub 2010 Jan 29.

DOI:10.1016/j.avsg.2009.09.018

PMID:20116206

Abstract

Vertigo provoked by head rotation is a classic symptom of rotational vertebrobasilar ischemia (RVBI). Inner ear disease can cause positional vertigo and mimic RVBI. We review the case of a patient with vertigo consistently triggered by leftward head rotation when supine. Computed tomography angiogram and dynamic arteriogram failed to show compression of the vertebral arteries with head rotation. Further evaluation revealed benign paroxysmal positional vertigo (BPPV) as the underlying etiology. Treatment of her BPPV led to complete resolution of her symptoms. A succinct overview of this common otologic disorder is provided, and strategies to help distinguish it from RVBI are discussed.

摘要

头部旋转引发的眩晕是旋转性椎基底动脉缺血（RVBI）的典型症状。内耳疾病可导致位置性眩晕并酷似RVBI。我们回顾了一例患者的病例，该患者仰卧时向左转头会持续引发眩晕。计算机断层扫描血管造影和动态动脉造影未显示头部旋转时椎动脉受压。进一步评估发现，潜在病因是良性阵发性位置性眩晕（BPPV）。对其BPPV的治疗使其症状完全缓解。本文提供了对这种常见耳科疾病的简要概述，并讨论了有助于将其与RVBI相鉴别的策略。