双侧椎动脉闭塞致双侧急性桥臂梗死一例

Bilateral middle cerebellar peduncle infarcts caused by bilateral vertebral artery occlusion:a case report

双侧椎动脉闭塞患者脑梗死发生率高,预后差,但双侧椎动脉闭塞致双侧桥臂梗死罕见.本文报道一例74岁男性患者因“头晕伴行走不稳13天”入院,头颅磁共振成像检查提示双侧急性桥臂梗死;脑部数字显影血管造影显示右侧椎动脉全程闭塞,左侧椎动脉近段闭塞,但侧支循环代偿较充分.经扩容、抗血小板聚集、调脂等治疗后,患者症状缓解,随访10个月恢复良好.

Patients with bilateral vertebral artery occlusion have a high incidence of cerebral infarction with poor prognosis. Infarction of bilateral middle cerebellar peduncle （MCP） is extremely rare and only a few cases have been reported in literature. A 74- year-old male patient was admitted to our hospital with a chief complaint of dizziness and walking instability for 13 d. Brain magnetic resonance image showed acute bilateral middle cerebellar peduncle infarction. Digital subtraction angiography showed occlusion of the initiation part of left vertebral artery and whole right vertebral artery, while a large amount of collateral circulations and recanalization were observed. After volume expansion, anti-platelet aggregation and lipid-lowering therapy, the symptoms disappeared. The patient was followed up for 10 months and he recovered well.