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小脑海绵状畸形所致眩晕:一例报告。

Vertigo due to cerebellar cavernous malformation: A case report.

作者信息

Maharani Putri, Hidayati Hanik Badriyah, Kurniawan Shahdevi Nandar

机构信息

Neurology Department, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia.

Neurology Department, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar General Hospital, Malang, Indonesia.

出版信息

Radiol Case Rep. 2022 Jul 27;17(10):3495-3500. doi: 10.1016/j.radcr.2022.06.088. eCollection 2022 Oct.

Abstract

Central vertigo is a result of vestibular structure dysfunction in the central nervous system. Currently, misdiagnoses between peripheral and central lesions are frequent, and diagnostic testing costs are high. Identifying the characteristics of these 2 conditions is challenging. We can provide better treatment if we can establish a diagnosis earlier. Cerebral cavernous malformation (CCM) at the cerebellum is a cerebellar lesion that causes symptoms of central vertigo. We report a patient, 20th years old, female, with vertigo for 1 month before being admitted. Vertigo was getting worse, and when the patient arrived at our hospital, vertigo was accompanied by headache, right and left abducens nerve palsy, horizontal nystagmus bidirectional, vertical nystagmus, and weakness on the right side of the body. A brain magnetic resonance imaging (MRI) was performed before surgery and shows a lesion suggestive of CCM at the cerebellum with a hemorrhagic component inside and non-communicating hydrocephalus. There is no vascular malformation based on digital subtraction angiography result. MRI is the most sensitive and specific modality for detecting CCM, whereas cerebral angiography rarely detects this malformation. The patient got surgical treatment, with suboccipital decompression procedures and CCM excision. The histopathological results after surgical treatment revealed a cerebral cavernous malformation. Vertigo, headache, double vision, and weakness on the right side of the body were resolved after surgery.

摘要

中枢性眩晕是中枢神经系统前庭结构功能障碍的结果。目前,外周性和中枢性病变之间的误诊屡见不鲜,且诊断检查费用高昂。鉴别这两种情况的特征具有挑战性。如果我们能更早地确诊,就能提供更好的治疗。小脑海绵状畸形(CCM)是一种导致中枢性眩晕症状的小脑病变。我们报告一例患者,20岁女性,入院前眩晕1个月。眩晕逐渐加重,患者到我院时,眩晕伴有头痛、双侧外展神经麻痹、双向水平眼球震颤、垂直眼球震颤以及身体右侧无力。术前进行了脑部磁共振成像(MRI)检查,显示小脑有一个提示为CCM的病变,内部有出血成分且伴有非交通性脑积水。数字减影血管造影结果显示无血管畸形。MRI是检测CCM最敏感和特异的方法,而脑血管造影很少能检测到这种畸形。患者接受了手术治疗,采用枕下减压术和CCM切除术。手术治疗后的组织病理学结果显示为脑海绵状畸形。术后眩晕、头痛、复视和身体右侧无力症状均得到缓解。

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