以對側突發性聽障爲前驅症狀的後下小腦動脈梗塞之眩暈症

Vertigo Caused by Posterior Inferior Cerebellar Artery Infarction with a Prodrome of Sudden Sensorineural Hearing Loss in the Contralateral Ear

魏培釗(Pei-Chao Wei) ； 范君揚(Jun-Yang Fan) ； 陳穆寬(Mu-Kuan Chen) ； 李國維(Kuo-Wei Lee)

《台灣耳鼻喉頭頸外科雜誌》 46卷1期 (2011/02) Pp. 56-60

https://doi.org/10.6286/2011.46.1.56

摘要

小腦梗塞雖只佔腦梗塞3%，卻是值得耳鼻喉科醫師注意的眩暈急症，它可以模仿周邊前庭與耳蝸病變的表現，除一般神經學檢查可能正常外，在耳神經學檢查中，也可能只有輕微的異常，加上中風的前驅症狀多樣，可以僞裝爲反覆發作的內耳疾病或突發性聽障，正確診斷需藉由詳細的問診、耳神經學檢查與考應患者中風危險因子，減少誤判的機會。我們報告一位以對側突發性聽障爲前驅症狀的後下小腦動脈內側枝梗塞之急性眩暈患者，並討論與周邊病因鑑別診斷要點。

關鍵字

小腦中風 ； 後下小腦動脈 ； 眩暈 ； 突發性聽障

並列摘要

Although cerebellar infarction accounts for only 3% of stroke cases, it is a causative factor of one of the most challenging forms of vertigo for otorhinolaryngologists. The symptoms and signs of this form of vertigo resemble those of other peripheral vestibulopathies and cochlear disorders. Further, in patients with this condition, general neurological examinations may yield normal findings and otoneurological investigations may reveal some trivial abnormalities. In patients with prodromata, cerebellar infarction can mimic recurrent inner-ear diseases or sudden sensorineural hearing loss. Therefore, for correct diagnosis, careful examination of the patient's medical history, thorough otoneurological investigations and understanding of the risk factors of stroke is essential. Here, we present a case of a vertiginous patient with infarction in the territory of medial branch of posterior inferior cerebellar artery and a prodrome of sudden sensorineural hearing loss in the contralateral ear. We discuss the differential diagnosis of vertigo between cerebellar infarction and peripheral causes.

並列關鍵字

cerebellar stroke ； PICA ； vertigo ； sudden sensorineural hearing loss