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以往报道小脑前下动脉(AICA)梗塞注重脑干和小脑的表现,没有详述神经耳科学的表现。本文报道2例 AICA 梗塞前单纯眩晕发作的病人,眼震电图(ENG)、听力检查和 MRI 证实有神经耳科学方面的损害。例1.男,75岁,有高血压、Ⅱ型糖尿病和冠心病。出现反复发作、周围环境旋转性眩晕,历时几分钟,间隔数周无症状。9个月后出现左手笨拙、轻微的躯干共济失调。早期听力检查正常,2周后示听力中度降低。前庭功能试验正常。12个月后入院。查体:左视向左搏动性眼震,右视变为向右搏动性眼震(Bruns 眼震),右下斜视,右面部感觉减退,右耳听力丧失,右肢辨距不良和步态失调。1天后出现右侧周围性面瘫。3天后听力检查示右耳听力完全丧失。ENG 示右耳双倍冷热刺激无反应。旋转试验表明向左转所得结果和双向时间常数降低。
Previous reports of anterior cerebellar artery (AICA) infarction focus on the performance of brainstem and cerebellum, neurological otology did not detail the performance. This article reports two patients with simple vertigo before AICA infarction, ocular electrogram (ENG), hearing tests and MRI confirmed neurological otology damage. Example 1. Male, 75 years old with high blood pressure, type II diabetes and coronary heart disease. Recurrent episodes, the surrounding rotating vertigo, which lasted a few minutes, a few weeks intervals asymptomatic. Nine months later left clumsiness, minor trunk ataxia. Early hearing test was normal, after 2 weeks reduced hearing moderate. Vestibular function test is normal. 12 months after admission. Physical examination: left to left pulsatile nystagmus, right to right pulsatile nystagmus (Bruns nystagmus), right lower strabismus, right facial sensory loss, right ear hearing loss, poor right-sided gait and gait Disorder. Right after 1 days appeared facial paralysis. 3 days after the hearing test showed complete loss of right ear hearing. ENG shows double stimulation of the right ear without response. Rotation tests showed a shift to the left and reduced bidirectional time constants.