以吞咽困难和言语含糊为表现的椎基底动脉延长扩张症2例报告及文献复习

Vertebrobasilar Dolichoectasia Presented with Dysphagia and Dysphonia:a Report of Two Cases

目的:通过个案报告及文献复习,企盼提高对椎基底动脉延长扩张症(vertebrobasilar dolichoectasia,VBD)的认识。方法:分析2例以吞咽困难和言语含糊为主要表现的VBD患者的临床资料并复习相关文献。结果:VBD是一种以椎基底动脉的增长、增粗及扭曲为主要特点的脑血管病,其临床表现除了脑干缺血或出血、蛛网膜下腔出血、脑干压迫所引起的症状以及脑积水以外,还包括吞咽困难和言语含糊。VBD的诊断主要依靠影像学检查,目前尚无理想的治疗方法,抗凝治疗对部分患者可能有效,但有出血风险。结论:以吞咽困难和言语含糊为主要表现的VBD易被误诊和漏诊,临床医师应注意提高对VBD的认识。

Objective： To improve the understanding of vertebrobasilar dolichoectasia（VBD）. Methods： The clinical features, imaging findings, diagnosis, treatment and follow-up data of two cases of VBD presented with dysphagia and dysphonia were analyzed retrospectively, and the literatures were reviewed. Results： As a cerebrovascular disease, the main characteristics of VBD were the marked elongation, widening and tortuosity of the intracranial vertebral and basilar arteries. The clinical mani- festations of VBD included not only cerebral ischemia or hemorrhage of brainstem, subarachnoid hemorrhage, compression symptoms of brainstem and hydrocephalus, but also dysphagia and dysphonia. The diagnosis of VBD mostly depended on ima- ging examinations. The treatment of VBD was still unclear, and anticoagulation therapy might be effective for some patients, but the risk of bleeding must be noticed. Conclusion： The VBD mainly presenting with dysphagia and dysphonia is easily misdi- agnosed and missed. Enough attention should be payed to this type of VBD.