急性前庭综合征和头晕的急诊表现。
Acute Vestibular Syndrome and ER Presentations of Dizziness.
机构信息
Department of Neurology and Neurological Sciences, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305, USA.
Department of Neurology and Neurological Sciences, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305, USA; Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305, USA.
出版信息
Otolaryngol Clin North Am. 2021 Oct;54(5):925-938. doi: 10.1016/j.otc.2021.05.013. Epub 2021 Jul 20.
Acute vestibular syndrome (AVS) describes sudden onset, severe, continuous dizziness that persists for more than 24 hours. Its wide differential presents a diagnostic challenge. Vestibular neuritis is the most common cause, but stroke, trauma, medication effects, infectious, and inflammatory causes all present similarly. The TiTrATE model (Timing, Triggers, And Targeted Exam) is systematic way to evaluate these patients, and the HINTS Plus exam (Head Impulse, Nystagmus, Test of Skew, plus hearing loss) is critical in differentiating central and peripheral causes. The importance of recognizing risk factors for stroke and the role of imaging is also discussed.
急性前庭综合征 (AVS) 描述的是突然发作、严重且持续超过 24 小时的持续性眩晕。其广泛的鉴别诊断具有挑战性。前庭神经炎是最常见的原因，但中风、外伤、药物作用、感染和炎症原因的表现相似。TiTrATE 模型（时机、诱因和靶向检查）是评估这些患者的系统方法，而 HINTS Plus 检查（头部脉冲、眼震、偏斜测试，加上听力损失）在区分中枢和外周原因方面至关重要。还讨论了识别中风风险因素和影像学作用的重要性。
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