后循环卒中致肥大性下橄榄核变性临床及影像表现

Clinical analysis and imaging findings of posterior circulation stroke induced hypertrophy of olive degeneration

目的分析肥大性下橄榄核变性(hypertrophic olivary degeneration,HOD)患者的病因、临床表现与影像学特点之间的内在关联。方法纳入2019-01—2020-05在郑州大学附属郑州中心医院因后循环卒中诊断为HOD的6例住院患者,分析其临床资料。结果6例患者均有齿状核、红核和下橄榄核神经元联系环路受损表现,其中脑桥3例,中脑合并脑桥1例,延髓1例,小脑1例。所有患者表现为急性脑血管病后遗症,分别于1~6个月出现新的临床表现,软腭震颤4例,眼震4例,复视3例,头部震颤及不自主运动2例,肢体震颤及不自主运动4例,舌肌震颤1例。头MRI示下橄榄核T2WI呈高信号。结论齿状核-红核-下橄榄核环路受累可继发肥大性下橄榄核变性,后循环卒中患者需警惕肥大性下橄榄核变性的发生。

Objective To observe the internal correlation between etiological changes,clinical manifestations,and imaging characteristics in hypertrophic oligodegeneration(HOD).Methods Six hospitalized patients with HOD after diagnosis of posterior circulation stroke in Zhengzhou Central Hospital affiliated to Zhengzhou University from January 2019 to May 2020 were included and their clinical data were analyzed.Results There were three cases of pons,1 case of middle brain with pons,1 case of medulla oblongata and 1 case of cerebellum.The sequelae of acute cerebrovascular disease presented new clinical manifestations in 1-6 months,including 4 cases of soft palate tremor,4 cases of ocular tremor,3 cases of diplopia,2 cases of head tremor and involuntary movements,4 cases of limb tremor and involuntary movements,and 1 case of tongue muscle tremor.Head MRI showed high signal in⁃tensity on T2WI in the olivary nucleus.Conclusion HOD can be secondary to the involvement of dentate nucleus red nucleus lower olive nucleus loop,and the occurrence of HOD should be observed in patients with postcirculatory stroke.