Abstract:

Objective To better understand the clinical feature of isolated vestibular syndrome of a vascular cause. Methods A retrospective analysis of 158 patients with posterior circulation infarction from the first hospital of Fangshan District of Beijing from January 2013 to December 2015 was performed. Cerebral MRI, vertebral artery color Doppler ultrasound, TCD and intracranial artery MRA were performed in all subjects, with CTA and DSA if necessary. According to clinical manifestation, all patients were divided into vertigo group and common group. Risk factors, clinical charateristic and infarction location were compared between the two groups. Results (1) There were 32 (20.3%) patients in vertigo group and 126 (79.7%) patients in common group. There were no statistical difference in age, hypertension, diabetes mellitus, dyslipidemia, smoking, and atrial fibrillation between the two groups. Posterior circulation artery stenosis rate was higher in vertigo group than that in common group (46.9% vs 32.5%, P =0.034) and the artery stenosis was more found in man (81.2% vs 50.8%, P =0.020). (2) Infarction in vertigo group mostly located in proximal vertebrobasilar artery territory (59.4% vs 34.1%, P =0.003), especially in PICA territory. (3) The false negative rate in initial DWI was higher in vertigo group (18.8% vs 3.0%, P =0.005), while the positive rate of the battery of head impulse test, nystagmus, test of skew (HINTS) was as high as 87.5% in vertigo group. Conclusions Compared common posterior circulation infarction, the patients with isolated vestibular syndrome had a higher rate of artery stenosis and a higher false negative rate in initial DWI, and their culprit lesions mostly located in proximal vertebrobasilar artery territory

Key words: Isolated vestibular syndrome; Infarction; Posterior circulation; Vertigo

摘要：

目的 分析血管性孤立性前庭综合征临床特点。 方法 收集房山区第一医院2013年1月-2015年12月住院的后循环脑梗死患者158例，均行头颅MRI、 椎动脉彩超、TCD、颅内动脉MRA检查，必要时进行CTA和（或）DSA检查。根据临床症状将病例分为 眩晕组（血管性孤立性前庭综合征）和普通组，比较两组危险因素、临床特点及病变部位的差异。 结果 ①眩晕组32例（20.3%），普通组126例（79.7%），两组在年龄、合并高血压、糖尿病、高脂血 症、吸烟及心房颤动比例方面均无统计学差异，但眩晕组后循环动脉狭窄率高于普通组（46.9% vs 32.5%，P =0.034）且男性多见（81.2% vs 50.8%，P =0.020）。②眩晕组病例病灶部位多位于椎基底 动脉近段供血区（59.4% vs 34.1%，P =0.003），以小脑前下部、延髓背外侧、小脑绒球最多见。③眩 晕组早期首次MRI DWI阴性率高于普通组（18.8% vs 3.0%，P =0.005），甩头试验-眼震-眼偏斜试验 （head impulse test，nystagmus，test of skew，HINTS）阳性率高达87.5%。 结论 血管性孤立性前庭综合征与普通后循环脑梗死相比动脉狭窄率高，病变部位多为近段脑梗 死，且MRI 检查假阴性率高。

关键词: 孤立性前庭综合征; 脑梗死; 后循环; 眩晕