急性桥臂梗死的临床特点

Clinical features of acute middle cerebellar peduncles infarction

目的研究急性桥臂梗死的临床特点。方法对27例急性桥臂梗死患者的临床资料进行回顾性分析。结果本组患者表现为头晕20例,其中伴行走不稳9例;恶心、呕吐10例,耳鸣4例,听力减退5例,水平性眼震5例,一侧眼球外展受限2例,中枢性面瘫2例,周围性面瘫3例,一侧肢体中枢性瘫痪5例,四肢瘫痪1例,一侧面部痛觉减退4例,共济失调9例。头颅CT检查示桥臂梗死10例(37%)。头颅MRI检查23例患者,均示桥臂长T1、长T2、DWI高信号的新梗死灶(100%),其中21例为单侧、2例为双侧桥臂梗死。结论急性桥臂梗死以前庭神经和小脑损害的表现为主,以及存在三叉神经、面神经、展神经和锥体束受累的表现。MRI对其诊断的准确性很高,应作为诊断的首选检查方法。

Objective To study the clinical features of acute middle cerebellar peduncles infarction. Methods The clinical data of 27 patients with acute middle cerebellar peduncles infarction were analyzed retrospectively. Results This group patients had the manifestation of dizziness 20 cases, with unstable walking 9 cases; nausea, vomiting 10 cases, tinnitus 4 cases, hearing loss 5 cases, horizontal nystagmus 5 cases, ocular motility disorders 2 cases, peripheral facial paralysis 3 cases, central facial palsy 2 cases, upper motor neuron paralysis on one side 5 cases, quadriplegia 1 case, hemifacial sensory disturbance 4 cases, ataxia 9 cases. Head CT examination showed 10 cases （37%） with cerebellar peduncle infarction. Head MRI examination of 23 patients showed cerebellar peduncle with new infarction of long Tl WI, T2WI, DWI high signal （ 100% ）, including unilateral 21 cases, bilateral 2 cases. Conclusions The main manifestation of middle cerebellar peduncle infarction are vestibular nerve and cerebellar impairment, and including the manifestation of trigeminal nerve, facial nerve, abducens nerve and pyramidal tract impairment. The diagnostic accuracy of MRI on it is very high, should be used as the first choice for examination.