Chen Y X, Sun X, Shi L Y, Wang N T, Peng X, Wang N, Ren C L, Shan X Z
Department of Otorhinolaryngology, General Hospital of Chinese People's Armed Police Forces,Beijing,100039,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Apr;32(7):547-550. doi: 10.13201/j.issn.1001-1781.2018.07.018.
To analyze the clinical characteristics of patients with cerebellar and brainstem infarction who initially presented with isolated vertigo to avoid misdiagnosing of this disease.Eleven patients with cerebellar and brainstem infarction who initially presented with isolated vertigo treated in our clinic between January 2014 and September 2017 were reviewed and the clinical characteristics and imaging presentation of the patients were evaluated.Vertigo as the first attack was in 5 cases, recurrent attacks was in 6 cases,10 cases were with vascular risk factors except for 1 case, initially diagnosed as vestibular neuritis was 4 cases, Meniere's disease was 1 case, posterior circulartion ischemia was 1 case,and unknown causes was 5 cases; delayed neurological symptoms and signs occurring was 4 cases, but not in other cases; finally determined by brain MRI as acute cerebellar infarction was 5 cases, brainstem infarction was 5 cases, and concurrent cerebellar and brainstem infarction was 1 case. All patients had good prognosis.Isolated vertigo due to posterior circulation infarction is easy to be misdiagnosed as peripheral vertigo.Patients presenting with isolated vertigo, when with vascular risk factors, should receive MRI and DWI examinations. Properly diagnosis and treatment may lead a good prognosis.
分析以孤立性眩晕为首发症状的小脑和脑干梗死患者的临床特征,以避免对该病的误诊。回顾性分析2014年1月至2017年9月在我院治疗的11例以孤立性眩晕为首发症状的小脑和脑干梗死患者,评估患者的临床特征及影像学表现。眩晕首发5例,反复发作6例;除1例无血管危险因素外,其余10例均有血管危险因素;初诊为前庭神经炎4例,梅尼埃病1例,后循环缺血1例,病因不明5例;出现延迟性神经症状和体征4例,其余病例未出现;最终经头颅MRI确诊为急性小脑梗死5例,脑干梗死5例,小脑和脑干同时梗死1例。所有患者预后良好。后循环梗死所致的孤立性眩晕易误诊为周围性眩晕。以孤立性眩晕就诊的患者,若有血管危险因素,应行MRI及DWI检查。正确诊断和治疗可获良好预后。