桥臂梗死18例临床及影像特征分析

Analysis of clinical and imaging characteristics of 18 patients with middle cerebellar peduncles infarction

目的探讨桥臂梗死的临床、影像特点及治疗预后。方法收集2007年1月-2014年8月江西省人民医院收治18例桥臂梗死患者的临床资料，并进行回顾性分析及复习相关文献。结果本组病例急性或亚急性起病，主要临床表现为眩晕、共济失调性步态伴或不伴恶心呕吐、周围性面瘫、面部感觉障碍、听力下降、Homer综合征。部分表现为吞咽困难、构音障碍等球麻痹，少数有锥体束受累表现。头颅MRI检查主要表现单侧桥臂伴或不伴其他后循环区长T1WI、长T2WI、弥散加权像高信号的梗死灶，其中1例为孤立的双侧桥臂梗死。本组病例经治疗后大部分预后良好，但桥臂梗死伴其他后循环区梗死预后较差。结论桥臂梗死在后循环梗死中少见，临床症状表现复杂。及时的头颅MRI有助于确诊，经积极的治疗预后相对良好。

Objective To explore the clinical features, imaging characteristics, treatment and prognosis of middle cerebellar peduncles infarction. Methods From January 2007 to August 2014, in the People＇s Hospital of Jiangxi Province, clinical data of 18 patients with middle cerebellar peduncles infarction were collected, retrospectively analyzed and lit- erature reviewed. Results This patients were acute or subacute onset, the manifestation included vertigo, ataxial gait, facial paralysis, facial sensory disturbance, hearing loss and Homer syndrome; some presented bulbar palsy; few had pyramidal tract impairment. Brain MRI revealed long T1WI, T2WI, DWI high signal of unilateral or bilateral middle cerebellar peduncle with or without other areas of posterior circulation.The sympotoms of all cases were partial resolved, but the patient with infarction of other areas of posterior circulation, were poorly recovered after treatment. Conclusion Middle cerebellar peduncles infarction is not commonly seen in the posterior circulation infarction, its manifestation is complicated, brain MRI is crucial for the diagnosis, the prognosis is relatively good after Dositivelv and effectively treatment.