Hashimoto Y, Kimura K, Terasaki T, Yonehara T, Uchino M
Department of Neurology, Kumamoto City Hospital.
Rinsho Shinkeigaku. 1997 Mar;37(3):253-6.
A 55-years-old woman had left neck pain and headache, dizziness, left Horner's sign, left abducens palsy, diplopia, left peripheral facial palsy, left loss of hearing, left tinnitus, left paralysis of vocal cord and soft palate, dysphagia, left limb ataxia, truncal ataxia, disturbance of temperature and pain sensation over Th10 on the right involving the right face. Left vertebral angiography revealed tapering occlusion of the left vertebral artery. Right vertebral angiography showed normal angiogram of the basilar artery and bilateral anterior inferior cerebellar arteries. MRI disclosed infarcts in the left lateral inferior pons, left lateral medulla, and cerebellum of territories in the anterior inferior cerebellar artery and posterior inferior cerebellar artery. T2 weighted image showed septum (intimal flap) in the left vertebral artery. This is the very rare case of lateral inferior pontine syndrome and lateral medullary syndrome due to the vertebral artery dissection.
一名55岁女性出现左侧颈部疼痛、头痛、头晕、左侧霍纳氏征、左侧展神经麻痹、复视、左侧周围性面瘫、左侧听力丧失、左侧耳鸣、左侧声带及软腭麻痹、吞咽困难、左侧肢体共济失调、躯干共济失调、右侧胸10平面温度及痛觉障碍并累及右侧面部。左侧椎动脉血管造影显示左侧椎动脉呈逐渐变细的闭塞。右侧椎动脉血管造影显示基底动脉及双侧小脑前下动脉血管造影正常。磁共振成像显示左侧脑桥下部外侧、左侧延髓外侧以及小脑前下动脉和小脑后下动脉供血区域梗死。T2加权像显示左侧椎动脉内有隔膜(内膜瓣)。这是一例极为罕见的因椎动脉夹层导致的脑桥下部外侧综合征和延髓外侧综合征。