以突發性耳聾及反覆眩暈為表現之前下小腦動脈梗塞

Anterior Inferior Cerebellar Artery Infarction Presented with Sudden Hearing Loss and Recurrent Vertigo

范振華(Jen-Hua Fan) ； 張淳翔(Chun-Hsiang Chang) ； 黃耀璋(Yaw-Chang Huang) ； 林凱南(Kai-Nan Lin) ； 陳正文(Jeng-Wen Chen)

《台灣耳鼻喉頭頸外科雜誌》 46卷5期 (2011/10) Pp. 277-281

https://doi.org/10.6286/2011.46.5.277

摘要

前下小腦動脈梗塞的臨床表現包括腦幹、小腦及內耳前庭症狀。若病人僅以突發性聽力損失及反覆眩暈等症狀表現，則不易早期診斷。本院經歷l名59歲女性，有糖尿病及高血脂症病史，因右側突發性耳聾住院接受dextran及類固醇治療，聽力雄雖部分改善，出院後仍出現反覆眩暈發作，再次入院時觀察發現朝向左側的水平迴旋性眼振，因眩暈持續超過24小時，且指鼻追蹤逕動（finger-nose-finger test）及快速交替翻掌運動（rapid alternating movement）出現右側輕微異常，經核磁共振檢查證實為前下小腦動脈梗塞。對於僅以突發性聽力損失及反覆眩暈等症狀求診的腦血管疾病高危險群病人，即使並未出現明顯神經學症狀，仍須將前下小腦動脈梗塞列入鑑別診斷。

關鍵字

前下小腦動脈 ； 小腦梗塞 ； 突發性聽力損失 ； 眩暈

並列摘要

Clinical manifestations of infarction to the anterior inferior cerebellar artery (AICA) include ischemic symptoms associated with the brainstem, cerebellum, and the peripheral cochleovestibular end organs. Early diagnosis of AICA infarction is difficult if a patient presents with only sudden loss of hearing and recurrent vertigo. A 59-yearold woman with a history of diabetes mellitus and hyperlipidemia was admitted to our ward for sudden deafness on the right side. Dextran and steroids were administered; however, despite some improvement in hearing, the patient suffered recurrent vertigo attacks following discharge from the hospital. Left-beating horizontal and torsional nystagmus, mild right side dysmetria in finger-nose-finger testing and rapid alternating movement were observed following re-admission. AICA infarction was later confirmed by MRI. Even without obvious neurological signs, AICA infarction should be included in the battery of differential diagnosis for patients at risk of cerebrovascular disease presenting with sudden hearing loss and recurrent vertigo.

並列關鍵字

anterior inferior cerebellar artery ； cerebellar infarction ； sudden hearing loss ； vertigo