Clinical characteristics of the brainstem infarction with dizziness as the first symptom
YANG Ying1 ZHANG Yongbo2▲
1.Internal Medicine, Beijing Shuili Hospital, Beijing 100036, China;
2.Department of Neurology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
Abstract：To investigate the clinical and imaging features of brainstem infarction with dizziness as the first symptom. Methods Eighty-seven brainstem infarction patients who had dizziness as the primary symptom in Department of Neurology in Beijing Friendship Hospital from March 2013 to August 2016 were recruited, and underwent MRI+DWI and CT angiography (CTA) examination. They were divided into three groups according to the distribution of affected lesions, the midbrain group, the pons group, and the medulla oblongata group, and their clinical characteristics were analyzed. Results Brainstem infarction with dizziness as the primary symptom mainly occurred in the pons, accounting for 68.97%, and the medulla oblongata accounted for 24.14% secondly. All patients were observed with dizzinessin, 18 cases (accounting for 20.69%) showed isolated dizziness(no other accompanying symptoms) among them, the most common associated symptom was unilateral limb weakness (accounting for 51.72%); the responsible vessel of midbrain infarction were mainly distributed in the posterior cerebral artery, and the pons were mainly distributed in the in basilar artery with mild-to-moderate narrow, the medulla oblongata were mainly distributed in the in vertebral artery with heavy-to-occlusive narrow. Conclusion Brainstem infarction with dizziness as the primary symptom mainly occurred in the pons. The most common associated symptom is unilateral limb weakness. Pathological vessels, the midbrain are mainly distributed in the posterior cerebral artery, and the pons mainly in basilar artery with mild-to-moderate narrow, the medulla oblongata mainly in vertebral artery with heavy-to-occlusive narrow.
杨颖1 张拥波2▲. 以头晕为首发症状的脑干梗死的临床特点[J]. 中国医药导报, 2019, 16(17): 129-132.
YANG Ying1 ZHANG Yongbo2▲. Clinical characteristics of the brainstem infarction with dizziness as the first symptom. 中国医药导报, 2019, 16(17): 129-132.
[1] Erro ME，Gallegory J，Herrera M，et al. Isolated pontine infarcts：etiopathogenic mcchanisms [J]. Eur J Nurol，2005， 12（12）：984-988.
[2] 中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南[J].中华神经内科杂志，2015，48（4）：246-257.
[3] Mair G，Boyd EV，Chappell FM，et al. Sensitivity and specificity of the hyperdense artery sign for arterial obstruction in acute ischemic stroke [J]. Stroke，2015，46（1）：102-107.
[4] 戚晓昆.重视头晕与眩晕的正确诊断[J].中华内科杂志，2014，53：761-766.
[5] 戚晓昆，王志伟.走出头晕与眩晕诊断的误区[J].北京医学，2015，37（5）：483-485.
[6] Venhovens J，Meulstee J，Verhagen WIM. Acute vestibular syndrome：a critial review and diagnostic algorithm concerning the clinical differentiation of peripheral versus central aetiologies in the emergency department [J]. J Neural，2016，263（11）：2151-2157.
[7] Lee H. Isolated vascular vertigo [J]. J Stroke，2014，16（3）：124-130.
[8] 陈玉辉，王音，徐蕾，等.后循环脑梗死的临床特点及相关危险因素分析[J].中国心血管杂志，2014，19（2）：101-104.
[9] Searls DE，Pazdera L，Korbel E，et al. Symptoms and signsof posterior circulation ischemia in the New England Medical Center Posterior Circulation Registry [J]. Arch Neurol，2012，69（3）：346-351.
[10] Lee SU，Park SH，Park JJ，et al. Dorsal medullary infarction：distinct syndrome of isolated central vestibulopathy [J]. Stroke，2015，46（11）：3081-3087.
[11] Kim HJ，Lee SH，Park JH，et al. Isolated vestibular nuclear infarction：report of two cases and review of the literature [J]. J Neurol，2014，261（1）：121-129.
[12] 陈红兵，王莹，李玲，等.累及脑桥表面和脑桥内部的单侧孤立性脑桥[J].中国神经精神疾病杂志，2011，37（5）：280-284.
[13] Nakamura Y，Hirayama T，Ikeda K. Clinicoradiologic features of vertebrobasil ardolichoectasia in stroke patient [J]. J Stroke Cerebrovasc Dis，2012，21（1）：5-10.
[14] 陈珂楠.脑桥旁正中梗死研究进展[J].中国临床神经科学，2012，20（1）：104-108.
[15] 熊静，张婕.217例脑干梗死患者血管病变分析[J].中国医药导报，2015，4（12）：80-84.
[16] Kim K，Lee HS，Jung YH，et al. Mechanism of medullary infarction based on artcrial lerritory involvement [J]. J Clin Neurol，2012，8（2）：116-120.
[17] Kameda W，Kawanami T，Kurita K，et al. Lateral and medial medullary infarction：acomparative analysis of 214 patients [J]. Stroke，2004，35：694-699.
[18] Gayatri P，Misra S，Menon G，et al. Transesophageal echocardiographic evaluation of left ventricular systolic and diastolic function in response to 20% mannitol and 3% hypertonic saline infusion in neurosurgical patients undergoing craniotomy [J]. J Neurosurg Anesthesiol，2014， 26（3）：187-191.
[19] Gan R，Noronha A. The medullary vascular syndromes revisited [J]. J Neurol，1995，242（4）：195-202.
[20] Hata Y，Yoshida K，Kinoshita K，et al. Sudden unexpected death owing to unilateral medial medullary infarction with early involvement of the respiratory center [J]. Leg Med（Tokyo），2014，16（3）：146-149.
[21] 孙阿萍，刘向一，孙庆利.延髓梗死的临床、影像学特点及预后分析[J].中华内科杂志，2016，55（5）：361-365.
[22] Kim JS. Pure later medullary infarction：clinical radiological correlation of 130 acute，consecutive patients [J]. Brain，2003，126（Pt8）：1864-1872.
[23] Katsuhiko O，Yutaka S，Minoru O，et al. Clinical study of twenty-one patients with pure midbrain infarction [J]. Eur Neurol，2012，67（2）：81-89.
[24] Anna MH，Janneke P，Joachim E，et al. Cost-effectiveness of CTA，MRA and DSA in patients with non-tranmatic subarachnoid haemorrhage [J]. Insights Imaging，2013，4（4）：499-507.
2019, Vol. 16 
京公网安备 11010502046598号