Uraguchi Kensuke, Kariya Shin, Oka Aiko, Tsumura Munetika, Ishihara Hisashi, Miyatake Tomomi, Hirata Yuji, Makihara Seiichiro, Nishizaki Kazunori
Nihon Jibiinkoka Gakkai Kaiho. 2016 Oct;119(10):1290-9.
Brainstem/cerebellar infarction is known to cause various cranial nerve symptoms that may require otorhinolaryngological evaluation. Acute-phase cerebellar infarction is evaluated by MRI with diffusion-weighted imaging (MRI-DWI). However, in the acute phase, MRI-DWI may show false-negative results, because of which patients are referred to the department of otolaryngology for further evaluation of the cranial nerve symptoms. We investigated 250 cases of brainstem/cerebellar infarction in 245 patients who were admitted to our hospital between 2010 and 2015. Of the 250 cases, eight cases were diagnosed at the department of otolaryngology after detailed evaluators for dizziness or dysphagia, and three of them were false negative on initial MRI-DWI. In total, we examined 16 cases detected as false negatives upon initial MRI-DWI. Of the 16 cases, 12 were brainstem infarctions, three were cerebellar infarctions, and one was infarction of the brainstem and cerebellum. All 16 cases were evaluated by initial MRI-DWI within 12 h of onset. Careful observation of the neurological findings and follow-up MRI-DWI are useful for the detailed evaluation of patients suspected to have a cerebellar infarction.
脑干/小脑梗死已知会导致各种颅神经症状,可能需要耳鼻喉科评估。急性期小脑梗死通过磁共振成像弥散加权成像(MRI-DWI)进行评估。然而,在急性期,MRI-DWI可能显示假阴性结果,因此患者会被转诊至耳鼻喉科,以进一步评估颅神经症状。我们调查了2010年至2015年间我院收治的245例患者中的250例脑干/小脑梗死病例。在这250例病例中,有8例在对头晕或吞咽困难进行详细评估后于耳鼻喉科确诊,其中3例在初次MRI-DWI检查时为假阴性。我们总共检查了16例初次MRI-DWI检查显示为假阴性的病例。在这16例病例中,12例为脑干梗死,3例为小脑梗死,1例为脑干和小脑梗死。所有16例病例均在发病后12小时内接受了初次MRI-DWI检查。仔细观察神经学表现并进行随访MRI-DWI检查,对于疑似小脑梗死患者的详细评估很有用。