以双耳听力下降为首发症状的脑梗死临床观察

Clinical observation of cerebral infarction with initial symptom of bilateral hearing loss

目的观察以双耳听力下降为首发症状的脑梗死患者,探讨其病灶分布特点及血管形态异常之间的关系。方法对3例以双耳听力下降为首发症状的脑梗死患者行头MR(包括T1WI、T2WI、DWI、MRA)、TCD、BAEP检查。结果 3例患者均为后循环多灶性梗死,最常累及的部位是小脑、脑桥,均有双侧椎动脉或基底动脉起始段严重狭窄或闭塞,双侧内听动脉均受累。结论以双耳听力下降为首发症状的脑梗死均符合多灶性后循环缺血的特点,血管形态异常是其重要病理基础和致病因素,预后差。

Objective To explore the correlation between the characteristics of cerebral infarction regions and vascular par amorphia by observing cerebral infarction cases whose initial symptom was bilateral hearing loss. Methods Three cerebral in- farction cases whose initial symptom was bilateral hearing loss were accepted MR（including T1 W1,T2 Wl, DWI, MRA）, TCD and BAEP examinations. Results In the 3 cases, examinations showed multiple infarction regions in posterior cerebral circula- tion, and the most Common regions were cerebellum and pons. Severe narrow or occlusion were found in the beginning period of bilateral vertebral artery or basilar artery, and bilateral internal aHditory arteries were involved. Conclusion This kind of cere- bral infarction whose initial symptom is bilateral hearing loss according to the features of muhiple infarction regions in posterior cerebral circulation. Vascular paramorphia is animportanl pathologic basis and pathogenic factor, and the prognosis is poor.