Wallenberg综合征临床与影像学分析

Clinical and neuroimaging characters in Wallenberg syndrome

目的探讨Wallenberg综合征的临床及影像学特点。方法根据MRI表现将36例Wallen-berg综合征患者分为上、中、下3组,并结合临床特点进行回顾性分析。其中13例行DSA检查。结果上部组多伴有吞咽困难、构音障碍、软腭麻痹,下部组多伴有眩晕、共济失调、眼球震颤。上部组及中部组病变多为斜带状,病变大都临近延髓腹内侧,下部组病变多为小片状,多位于延髓背外侧表浅部分。DSA检查6例均存在不同程度椎动脉病变,2例示小脑后下动脉闭塞,1例示椎动脉闭塞伴同侧小脑后下动脉狭窄。结论Wallenberg综合征病变部位与临床症状有关。DSA检查可以进一步明确病因及病变程度。

Objective To investigate the clinical manifestations,and neuroimaging features of Wallenberg syndrome. Methods With MRI finding,36 patients with Wallenberg syndrome were divided into upper medulla group, medial medulla group and lower medulla group, and retrospectively analyzed with clinical manifestation. DSA were performed in 13 patients. Results Dysphagia,dysarthria and soft palateg weakness were frequent clinical findings in upper medulla group, whereas vertigo, gait ataxia and nystagmus were usually in lower medulla group. The lesions located in the upper and medial groups were usually diagonal band shaped, closed to ventralis medialis of the medulla. The lower medial group, the losions were usually in the lateral surface of the medulla and appeared in fragments DSA showed 6 patients with different degree of vertebral disease,2 patients with isolated posterior inferior cerebellar artery occlusion and, 1 patient with vertebral occlusion and ipsilateral posterior inferior cerebellar artery stenosis. Conclusion There is obviously correlation between diseased region and clinical symptoms pathogenesis and the degree of disease can be identified by DSA.