中枢性孤立性眩晕的临床特点及影像学分析  

Clinical characteristics and imaging analysis of central isolated vertigo

作　　者：王维 宫萍[2] Wang Wei;Gong Ping(Department of Neurology,China Civil Aviation General Hospital,Beijing 100123,China;Department of Geriatric Medicine,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]民航总医院神经内科,北京100123 [2]北京大学第三医院老年病内科,北京100191

出　　处：《首都医科大学学报》2024年第2期333-339,共7页Journal of Capital Medical University

基　　金：国家自然科学基金资助项目(82273712)。

摘　　要：目的加深对孤立性眩晕起病的急性脑梗死的认识。方法回顾性分析2020年8月至2022年8月民航总医院神经内科收治的由孤立性眩晕起病的急性脑梗死患者(病例组25例)及非急性脑梗死患者(对照组25例),分析其人口学特征、脑血管病危险因素及影像学特征。结果病例组中男性比例以及55岁以上患者比例显著高于对照组[分别为72%vs 44%,80%vs 52%(P<0.05)]。病例组中合并高血压和糖尿病的比例均高于对照组,(分别为72%vs 56%,52%vs 40%),合并高脂血症的比例少于对照组(84%vs 96%),差异无统计学意义(P>0.05)。病例组中临床表现为恶心、呕吐、听力下降和眼球震颤的比例多于对照组(分别为68%vs 56%,52%vs 40%,16%vs 4%,24%vs 16%),而表现为耳鸣的比例少于对照组(8%vs 16%),组间差异无统计学意义(P>0.05)。病例组中小脑梗死18例(72%),脑干梗死5例(20%),枕叶梗死1例(4%),海马梗死1例(4%)。结论以孤立性眩晕起病的急性脑梗死患者中男性发生急性脑梗死的风险显著高于女性,55岁以上患者风险显著高于55岁以下成年患者。头颅磁共振成像提示梗死部位多为椎基底动脉系统供血区病变:主要位于小脑及脑干。Objective To deepen the understanding of acute cerebral infarction with the onset of isolated vertigo.Methods We retrospectively analyzed the patients with the onset of isolated vertigo that were previously treated in Department of Neurology,China Civil Aviation General Hospital.They were divided into acute cerebral infarction group(25 cases in the case group)and non-acute cerebral infarction group(25 cases in the control group).The demographic characteristics,risk factors of cerebrovascular disease and imaging characteristics were analyzed.Results In the case group,the proportions of males and the patients who were over 55 years old were significantly higher than those of control group(72%vs 44%and 80%vs 52%,respectively,P<0.05).The proportions of patients with hypertension and diabetes in the case group were higher than those in the control group(72%vs 56%,52%vs 40%,respectively),and the proportion of patients with hyperlipidemia was lower than those in the control group(84%vs 96%).There was no significant difference between the two groups(P>0.05).The proportions of clinical manifestations with nausea,vomiting,hearing loss and nystagmus in the case group were higher than those in the control group(68%vs 56%,52%vs 40%,16%vs 4%,and 24%vs 16%,respectively),while the proportion of tinnitus was lower than that in the control group(8%vs 16%).There was no significant difference between the two groups(P>0.05).In the case group,there were 18 cases(72%)of cerebellar infarction,5 cases(20%)of brainstem infarction,1 case(4%)of occipital lobe infarction and 1 case(4%)of hippocampus infarction.Conclusion Among patients with acute cerebral infarction who started with isolated vertigo,Men had a significantly higher risk of acute cerebral infarction than women,and patients over 55 years old had a significantly higher risk than the adult patients under 55 years old.2.Head magnetic resonance imaging showed most of the infarction sites were in the blood supply area of the vertebrobasilar artery system:located mainly in the cerebel

关 键 词：孤立性眩晕 急性脑梗死 椎基底动脉系统 

分 类 号：R743[医药卫生—神经病学与精神病学]