25例头晕及后循环梗死病例特点分析

Clinical characteristic of 25 patients with dizziness and infarction of posterior circulation

目的总结后循环梗死患者的临床特点。方法收集2016年1月至2019年5月解放军总医院第六医学中心和河南圣德医院眩晕中心诊治的以急性头晕为主要症状,经头颅MRI确定为后循环急性梗死的25例患者的临床资料。结果25例患者,男19例,女6例;年龄35~91岁,平均63岁。发病前共有11例出现过孤立性头晕,占44.0%。伴有听力下降或耳鸣者3例,与后循环梗死侧别一致。平卧时有阳性体征14例,无阳性体征11例,无阳性体征者占44.0%。单纯小脑下后动脉内侧支支配区梗死11例,8例平卧时无阳性体征,9例主诉眩晕,2例主诉非眩晕头晕。结论后循环梗死部分病例出现孤立性头晕、梗死前阵发性头晕,伴有同侧听力下降或耳鸣,平卧时无阳性体征的特点。掌握这些特点,有助于正确诊断,避免误诊为周围性头晕。

Objective To summarize the clinical characteristics of the patients with dizziness and infarction in posterior circulation.Methods The data of 25 patients with acute dizziness and acute infarction of posterior circulation identified by MRI were investigated.Results There were 11 cases(44.0%)with isolated dizziness.The isolated dizziness occurred in 11 cases before the infarction.Three cases were accompanied by tinnitus and deafness in the infarction side.Eleven cases(44.0%)had no signs in the supine position when examined by the neurologist.Among 11 cases with infarction in mPICA territory,eight cases had no signs in the supine position,nine cases complained vertigo and two complained non-vertigo dizziness.Conclusions The patients with infarction in the posterior circulation have some features,such as isolated dizziness,episodic dizziness before the infarction,tinnitus and deafness in the same side as the infarction and no signs in the supine position.These characteristics may be helpful to correct diagnosis and avoid misdiagnosis as peripheral vertigo.