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中华卫生应急电子杂志 ›› 2021, Vol. 07 ›› Issue (04) : 240 -243. doi: 10.3877/cma.j.issn.2095-9133.2021.04.011

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急性脑血管病继发肥大性下橄榄核变性的临床特点
赵媛1, 张梅1,()   
  1. 1. 101300 北京,北京市顺义区医院神经内科
  • 收稿日期:2020-04-24 出版日期:2021-09-10
  • 通信作者: 张梅

Clinical characteristics of hypertrophic inferior olivary nucleus degeneration secondary to acute cerebrovascular diseas

Yuan Zhao1, Mei Zhang1()   

  • Received:2020-04-24 Published:2021-09-10
  • Corresponding author: Mei Zhang
引用本文:

赵媛, 张梅. 急性脑血管病继发肥大性下橄榄核变性的临床特点[J]. 中华卫生应急电子杂志, 2021, 07(04): 240-243.

Yuan Zhao, Mei Zhang. Clinical characteristics of hypertrophic inferior olivary nucleus degeneration secondary to acute cerebrovascular diseas[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2021, 07(04): 240-243.

表1 8例急性脑血管病继发HOD患者的基线资料
表2 8例急性脑血管病继发HOD患者的临床及影像学表现
编号 临床症状 遗留症状 阳性体征 HOD影像学表现
1 行走不稳,言语不清,饮水呛咳 腭肌震颤眼动障碍共济失调 左侧小脑半球多发微出血灶;双侧下橄榄核腹外侧核等T1长T2信号,FLAIR高信号
2 行走不稳,言语不清,头部震颤 双下肢无力 腭肌震颤垂直性眼震慌张步态四肢肌张力增高 脑桥软化灶、多发微出血灶;双侧下橄榄核稍长T1及长T2信号,FLAIR高信号,矢状面T1加权像示局限性下橄榄核体积增大
3 言语不清,饮水呛咳 头晕 共济失调垂直性眼震 右侧脑桥被盖部陈旧性梗死病灶;右侧下橄榄核稍长T1及长T2信号,FLAIR高信号
4 头、四肢不自主震颤,言语不清 右肢轻度无力,轻度构音障碍 眼球浮动腭肌震颤共济失调 双侧脑桥被盖部陈旧性出血改变;双侧下橄榄核对称类圆形稍长T1长T2信号FLAIR稍高信号;脑桥多发斑点状低信号,考虑隐匿性血管畸形伴含铁血黄素沉积可能性大(海绵状血管瘤可能大)。见图1
5 口周及下颌部震颤;躯干四肢不自主扭转抖动 腭肌震颤垂直性眼震,四肢肌张力增高 右侧小脑半球陈旧性梗死灶;左侧延髓下橄榄核等T1长T2信号,FLAIR高信号,矢状面T1加权像示局限性下橄榄核体积增大
6 四肢、头部不自主震颤 饮水呛咳,左肢无力 腭肌震颤慌张步态共济失调 双侧桥脑被盖部多发微出血、腔隙性梗死病灶;双侧延髓下橄榄核稍长T1长T2信号,FLAIR高信号
7 行走不稳,饮水呛咳 共济失调腭肌震颤 右侧小脑软化灶,双侧下橄榄体核腹外侧核稍长T1长T2信号,FLAIR高信号
8 头晕,言语不清,头部不自主震颤 头晕 构音障碍共济失调 双侧桥臂陈旧性梗死病灶,双侧延髓下橄榄体核长T1长T2信号,FLAIR高信号
图1 急性脑血管病继发HOD患者4的MRI表现
表3 8例HOD患者治疗手段及预后
图2 格莫三角模式图
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