Holmøy T
Nevrologisk avdeling, Lillehammer fylkessykehus.
Tidsskr Nor Laegeforen. 1993 Aug 30;113(20):2564-5.
Infarction of the cerebellum comprises about 1.5 percent of all strokes. The symptoms are initially very similar to those of benign labyrinthitis, and the diagnosis is easy to miss. There are three major causes of clinical deterioration and death: Expansion of the infarct to the brainstem, swelling of the infarcted cerebellum with compression of the brainstem, and hydrocephalus. Surgical intervention may be lifesaving if hydrocephalus develops. Five patients admitted to our department are described. All described sudden vertigo or dizziness, which in three of them was accompanied by headache. All had ataxia. In four this was ipsilateral to the infarction and in one bilateral. Two had slight hemiparesis and plantar inversion. Two patients developed hydrocephalus. One was operated with external drainage. It is important to have this diagnosis in mind in all patients with acute labyrinthine symptoms. Acute CT scanning should be carried out if the patient becomes less conscious.
小脑梗死约占所有中风的1.5%。其症状最初与良性迷路炎非常相似,诊断很容易被遗漏。临床病情恶化和死亡有三个主要原因:梗死灶扩展至脑干、梗死的小脑肿胀压迫脑干以及脑积水。如果发生脑积水,手术干预可能挽救生命。本文描述了我院收治的5例患者。所有患者均出现突发眩晕或头晕,其中3例伴有头痛。所有患者均有共济失调,4例为梗死侧同侧共济失调,1例为双侧共济失调。2例有轻度偏瘫和跖屈内翻。2例患者出现脑积水,1例行外部引流手术。对于所有有急性迷路症状的患者,都应考虑到这一诊断。如果患者意识变差,应进行急性CT扫描。