Izumi M, Terao S, Sobue G, Koshimura J, Takatsu S, Yokoi Y, Takahashi M, Mitsuma T
Fourth Department of Internal Medicine, Aichi Medical University, Japan.
No To Shinkei. 1996 Feb;49(2):152-6.
Clinical features of the anterior inferior cerebellar artery (AICA) territory infarcts were investigated in ten patients, ranging in age from 38 to 76 years. In all patients, there were MR images of infarction located in the area supplied by the AICA. The lesion was on the left side in 6 patients and right side in 4. The lesion of brain stem including the middle cerebellar peduncle was found in 7 patients and that extended to the cerebellum was in 3 patients. The main ipsilateral neurological signs were the VII and VIII cranial nerves palsy and cerebellar ataxia. The V and VI cranial nerves palsy. Horner's syndrome, and dysphagia were also present. The main contralateral sign was superficial sensory disturbance, but no hemiplegia. The underlying pathology included chiefly hyperlipidemia, hypertension, and diabetes mellitus. Cerebral angiography was performed in 8 patients, most of which was observed severe arteriosclerosis suggesting poor hemodynamics in the vertebral and basilar arteries. The prognosis was relatively good, but the VII, VIII, and V cranial nerves palsy and contralateral superficial sensory disturbance remained as the sequelae. As mentioned above, there were various neurological findings and MR images in AICA territory infarcts. Especially there were some patients whose lesion extended to the upper medulla and neurological findings were similar to the Wallenberg syndrome. It is important that one investigates not only axial slices but also coronal slices of MR image to estimate the extension of AICA territory infarct.
对10例年龄在38至76岁之间的患者进行了小脑前下动脉(AICA)供血区梗死的临床特征研究。所有患者均有位于AICA供血区的梗死的磁共振成像(MR)图像。病变位于左侧的有6例,位于右侧的有4例。7例患者发现包括小脑中脚在内的脑干病变,3例患者病变延伸至小脑。同侧主要神经体征为Ⅶ、Ⅷ颅神经麻痹和小脑共济失调。还存在Ⅴ、Ⅵ颅神经麻痹、霍纳综合征和吞咽困难。对侧主要体征为浅感觉障碍,但无偏瘫。潜在病理主要包括高脂血症、高血压和糖尿病。8例患者进行了脑血管造影,其中大多数观察到严重动脉硬化,提示椎基底动脉血流动力学不良。预后相对较好,但Ⅶ、Ⅷ和Ⅴ颅神经麻痹及对侧浅感觉障碍仍作为后遗症存在。如上所述,AICA供血区梗死有各种神经学表现和MR图像。特别是有一些患者病变延伸至上延髓,神经学表现与延髓背外侧综合征相似。重要的是,为了评估AICA供血区梗死的范围,不仅要研究MR图像的轴位切片,还要研究冠状位切片。