Kumar A, Mafee M, Dobben G, Whipple M, Pieri A
Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, Illinois, USA.
Ear Nose Throat J. 1998 Dec;77(12):966-9, 972-4.
As isolated symptoms, vertigo, dizziness and imbalance are not regarded by neurologists as reflections of transient ischemia in the vertebrobasilar circulation. The purpose of this retrospective study was to demonstrate that these symptoms can and do occur in isolation. To this end, we analyzed the symptoms, stroke risk factors and diagnostic algorithms in 27 patients with a diagnosis of transient vertebrobasilar ischemia. None of the 27 patients included in the review complained of any associated neurologic symptoms. Against the reference standard of brain imaging, the site of the pathologic lesion was defined in the brainstem/cerebellum with the Torok monothermal caloric test, with a sensitivity greater than 86%. Vestibular decruitment and hyperactive caloric responses were of particular diagnostic value. Thus, we recommend that the neurologic dogma with regard to brainstem cerebellar ischemia be rethought.
作为孤立症状，眩晕、头晕和失衡并不被神经科医生视为椎基底动脉循环短暂性缺血的反映。这项回顾性研究的目的是证明这些症状能够且确实会孤立出现。为此，我们分析了27例诊断为短暂性椎基底动脉缺血患者的症状、中风危险因素及诊断算法。纳入该综述的27例患者均未主诉任何相关神经症状。对照脑成像参考标准，通过托罗克单温冷热试验确定脑干/小脑的病理性病变部位，其敏感性大于86%。前庭减敏和热反应亢进具有特别的诊断价值。因此，我们建议重新思考关于脑干小脑缺血的神经学教条。
