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小脑梗死临床误诊分析

王海虹 王适达 张立娜 张晓宇

临床误诊误治2023,Vol.36Issue(7):19-22,4.
临床误诊误治2023,Vol.36Issue(7):19-22,4.DOI:10.3969/j.issn.1002-3429.2023.07.006

小脑梗死临床误诊分析

Analysis of Clinical Misdiagnosis of Cerebellar Infarction

王海虹 1王适达 2张立娜 3张晓宇4

作者信息

  • 1. 072750 河北 涿州,保定市第二中心医院神经内2科
  • 2. 072750 河北 涿州,保定市第二中心医院功能科
  • 3. 072750 河北 涿州,保定市第二中心医院老年病科
  • 4. 072750 河北 涿州,保定市第二中心医院神经内1科
  • 折叠

摘要

Abstract

Objective To explore the causes of misdiagnosis and preventive measures of cerebellar infarction.Meth-ods The clinical data of 10 patients with cerebellar infarction who were early misdiagnosed as vertebrobasilar artery insuffi-ciency and Meniere's disease admitted to our hospital from April 2020 to October 2022 were retrospectively analyzed.Results The initial symptoms of 10 cases were vertigo,nausea,vomiting,vision rotation in 4 cases,headache in 5 cases,difficulty in walking in 5 cases,tinnitus in 4 cases,and history of blood pressure in 6 cases.All cases had horizontal nystagmus,ac-companied by ataxia in 5 cases,hearing loss in 4 cases,peripheral facial paralysis in 1 case,hemiplegia in 3 cases,and hy-potonia in 2 cases.No responsible lesion was found in 10 cases after admission by head CT plain scan.Six patients underwent transcranial Doppler ultrasonography,which showed poor elasticity and slow blood flow of both vertebrobasilar arteries.The in-itial consideration was that there were 6 cases of insufficient blood supply to vertebrobasilar artery and 4 cases of Meniere's dis-ease.After corresponding symptomatic treatment,the symptoms did not improve significantly or even worsened.CT and MRI examination confirmed cerebellar infarction.The duration of misdiagnosis was 2-3 d.After diagnosis and symptomatic treat-ment,9 cases recovered well and 1 case had mild neurological symptoms.Conclusion Early symptoms of cerebellar infarc-tion are not typical,and it is more likely to lead to misdiagnosis at early stage.Clinicians should strengthen the understanding of the disease,perform conventional CT examination,and perform repeated CT or MRI examination when necessary,thus ef-fectively avoiding misdiagnosis.

关键词

小脑梗死/误诊/椎基底动脉供血不足/梅尼埃病/眼震/面神经麻痹/体层摄影术,螺旋计算机/磁共振成像

Key words

Cerebellar infarction/Misdiagnosis/Insufficient blood supply to vertebrobasilar artery/Meniere's dis-ease/Nystagmus/Facial paralysis/Tomography,spiral computed/Magnetic resonance imaging

分类

临床医学

引用本文复制引用

王海虹,王适达,张立娜,张晓宇..小脑梗死临床误诊分析[J].临床误诊误治,2023,36(7):19-22,4.

临床误诊误治

OACSTPCD

1002-3429

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