Nakaso K, Nakayasu H, Isoe K, Nakashima K, Takahashi K
Division of Neurology, Faculty of Medicine, Tottori University, School of Medicine.
Rinsho Shinkeigaku. 1995 Sep;35(9):1040-3.
Here we report a 47-year-old man with dissecting aneurysm of the basilar artery who developed Foville's syndrome due to upper pons involvement. At first he had an abrupt onset of dysarthria and weakness in his left upper and lower extremities during his work. Neurological examination on admission revealed mild disturbance of consciousness, absent light reaction on the left side, hypesthesia of the left face, absent gag reflex, dysarthria, and left hemiparesis with ataxia. On the second hospital day he developed paralysis of conjugate eye movement to the right, left central facial palsy, and left hemiplegia, and hyperhidrosis of the left side of the body. He was diagnosed to have superior pons type of Foville's syndrome. Computed tomography showed low density area in the right upper pons, and the basilar artery had marked lateral shift, dilatation, and calcification. Vertebral angiography demonstrated dissecting aneurysm of the basilar artery. Although it is very rare that dissecting aneurysm of the basilar artery causes the brain stem symptoms, its possibility should be considered when computed tomography shows marked lateral shift, dilatation, and/or calcification of the basilar artery.
在此，我们报告一例47岁男性，患有基底动脉夹层动脉瘤，因上脑桥受累而出现福维尔综合征。起初，他在工作期间突然出现构音障碍以及左上肢和下肢无力。入院时的神经系统检查发现意识轻度障碍、左侧光反射消失、左侧面部感觉减退、咽反射消失、构音障碍、伴有共济失调的左侧偏瘫。在住院第二天，他出现了向右的共轭眼球运动麻痹、左侧中枢性面瘫、左侧偏瘫以及身体左侧多汗。他被诊断为脑桥上型福维尔综合征。计算机断层扫描显示右上脑桥有低密度区，基底动脉有明显的侧向移位、扩张和钙化。椎动脉血管造影显示基底动脉夹层动脉瘤。虽然基底动脉夹层动脉瘤导致脑干症状非常罕见，但当计算机断层扫描显示基底动脉有明显的侧向移位、扩张和/或钙化时，应考虑其可能性。
