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目的 研究老年人小脑前下动脉 (AICA)区脑梗死的临床特点。 方法 对我院 1997~2 0 0 0年 4年间通过磁共振成像 (MRI)确诊的 10例老年人AICA区脑梗死连续病例从发生率、病因学、急性期临床特点及预后几方面进行探讨。 结果 老年人AICA区脑梗死占AICA区脑梗死的 5 8 8%,占同期老年人小脑梗死的 2 2 7%。高脂血症、高血压、糖尿病是其主要的危险因素。病因不同于青年人AICA区脑梗死患者 ,而是以动脉粥样硬化为主。一般AICA区脑梗死的临床表现在老年人AICA区脑梗死中均可出现 ,所有患者均有眩晕及小脑性共济失调的症状、体征 ;除 1例患者外 ,均有颅神经受累 ,以Ⅷ、Ⅶ、Ⅴ、Ⅸ最多见。第Ⅷ颅神经受累是AICA区脑梗死的一个特征性改变。老年人AICA区脑梗死预后较好。 结论 应提高对老年人AICA区脑梗死临床特点的认识 ,以降低误诊率。
Objective To study the clinical features of cerebral infarction in the anterior inferior cerebellar artery (AICA) in the elderly. Methods The consecutive cases of cerebral infarction in 10 elderly patients with AICA diagnosed by magnetic resonance imaging (MRI) from 1997 to 2000 in our hospital were studied in terms of incidence, etiology, clinical features and prognosis. Results Cerebral infarction in AICA area accounted for 58.8% of the infarction area in AICA area and accounted for 22.7% of the infarction area in the same period. Hyperlipidemia, hypertension and diabetes are the main risk factors. The cause is different from young AICA patients with cerebral infarction, but based on atherosclerosis. The clinical manifestations of cerebral infarction in general AICA area may appear in cerebral infarction of AICA in the elderly, all patients have symptoms and signs of dizziness and cerebellar ataxia. Except for 1 patient, all have cranial nerve involvement, , Ⅶ, Ⅴ, Ⅸ the most common. Ⅷ cranial nerve involvement is a characteristic change of cerebral infarction in AICA area. The prognosis of cerebral infarction in the elderly AICA area is good. Conclusion Awareness of the clinical features of cerebral infarction in AICA area should be improved to reduce the misdiagnosis rate.