单纯发作性眩晕性脑干梗死30例临床和MRI分析

Analysis of clinical features and MRI of 30 patients with infarction of brain stem associated with paroxysmal vertigo

目的 探讨对以发作性眩晕为主的椎 -基底动脉缺血老年患者发作次数、持续时间与脑干梗死的关系。方法 分析 3 0例椎 -基底动脉缺血以发作性眩晕为表现的患者临床特点及磁共振成像 (MRI)表现。结果 患者平均年龄 >60岁 ,6例每日发作 1次 ,每次发作持续时间 >1h,2 4例为每日反复发作≥ 5次 ,每次发作持续 5～2 0 min,无神经系统阳性体征。头颅 MRI检查前全部患者临床诊断为椎 -基底动脉缺血发作 ,头颅 MRI检查后确诊为脑干梗死。结论 对于单纯表现为发作性眩晕 ,特别是年龄 >60岁的患者 ,眩晕每日反复发作≥ 5次或每次持续时间 >1h。

Objective Reminding physicians to consider the possibility of brain stem infarction when old patients with vertebrobasilar insufficiency had paroxysmal vertigo attacks every day or if each attack had lasted for over an hour.Methods Analy zing the clinical characteristics and MRI results of 30 patients with vertigo related to vertebrobasilar insufficiency.Results The mean age of patients were over 60.Six patients had an attack which had lasted for over an hour per day,24 patients got attacks≥5 times and each attack had lasted for 5～20 minutes per day.All the patients had no positive signs during physical examimation.Conclusions We should consider the possibility of brain stem infarction in patients with simple paroxysmal vertigo,especially when their age is over 60 and they got attacks≥5 times per day or each attack had lasted over an hour.