Wallenberg综合征临床特点、CT与MRI

Clinical CT and MRI characteristics of wallenberg's syndrome

关键词:  Wallenberg综合征  小脑后下动脉  CT  MRI

Key words:  wallenberg's syndrome  inferior cerebellar artery  CT  MRI

摘要:

探讨Wallenberg综合征病因、临床表现及CT、MRI改变。方法：分析1992～1998年住院诊断为Wallenberg综合征17例病人病因，临床表现，CT与MRI改变。结果：Wallenberg综合征病因主要为小脑后下动脉缺血所致，但也有出血性疾病。临床主要表现为：病灶侧软腭声带麻痹，咽反射消失(94.1%)，病灶侧面部及对侧痛温觉障碍(88.2%)，病灶同侧Horner征(82.4%)，病灶同侧小脑性共济失调(70.6%)，眩晕(70.6%)，恶心、呕吐(58.8%)，水平眼震(52.9%)，头痛(23.5%)，呃逆(17.6%)，病灶对侧肢体轻瘫(11.8%)。17例病人发病72 h内行头部CT扫描，1例发现延髓有出血，另16例延髓无异常改变。发病72.h内头部MRI检查，9例延髓有异常信号改变，5例小脑有异常信号改变，2例基底节区有异常信号改变。结论：Wallenberg是一组多病因综合征。MRI检查优于CT，但并不是所有Wallenberg综合征MRI检查均有阳性发现。

Abstract:

To investigate the pathogeny,clinical CT and MRI characteristics of Wallenberg's syndrom. Methods: 17 cases of wallenberg's syndrome were analysed who had received and diagnosed in our hospital from 1992 to 1998.Results:The pathogeny of Wallenberg's syndrome mainly was caused by ischemia of the posterior inferior cerebellar artery, but sometimes was caused by hemorrhage diseases. The clinical manifestations were observed: focal lateral vocal cords paralysis of soft palate,and gag reflex disappear(94.1%), ipsilateral sensory (pain and heat)impairment of the face and contralateral else where(88.2%), focal ipsilateral Horner syndrome(82.4%), focal ipsilateral cerebeller ataxia(70.6%), vertigo(70.6%), nauseatation,vomit(58.8%), level nystagmus(52.9%), headache(23.5%), niccough(17.6%), focal contra lateral limbs paresis(11.8%). Swenteen patients were tested with cranial CT scanning after occurrence in 72 hours, in which 1 case had medulla oblongata hemorrhage. However with MRI scanning 9 cases had abnormal signal change in medulla oblongata, 5 cases had abnormal signal change in cerebellum, 2 cases had abnormal signal in basal ganglion. Conclusion:Wallenberg is a group of multipathogeny syndrome.MRI was better than CT, in diagnosis of the reasons of the syndrome