急性桥臂梗死的临床及影像学特征

目的:探讨急性桥臂梗死的临床及影像学特点。方法:回顾性分析2014年8月至2017年9月我院收治的20例急性桥臂梗死患者的临床及影像学资料。患者均于发病48 h内完成首次颅脑CT检查，3d内完成首次颅脑MRI检查，8例病程中有MRA检查资料。结果:本组患者均急性起病，均伴眩晕，共济失调性步态16例，恶心呕吐13例，耳鸣、听力下降7例，水平性眼震5例，一侧眼球外展受限3例，面瘫3例，Horner综合征3例，肢体瘫痪1例。首次CT检查阴性13例，随访CT可见桥臂低密度灶。头颅MRI均示桥臂T1WI低、T2WI、FLAIR及DWI高信号，ADC低信号，其中单侧16例，双侧4例。MRI还显示10例伴发的其他后循环区域急性梗死。结论:急性桥臂梗死临床表现复杂多样，多以前庭神经和小脑损害的表现为主。影像学检查尤其是及时的MRI有助于诊断及鉴别诊断。 

Clinical and Imaging Features of Acute Pontine Brachium Infarction

Objective: To investigate the clinical and imaging characteristics of acute pontine brachium infarction. Methods: The clinical and imaging data of 20 patients with acute pontine brachium infarction admitted at our hospital from August 2014 to September 2017 were analyzed retrospectively. All patients underwent the first brain CT examination within 48 h and the first MRI examination within 3 d. 8 cases had MRA examination data. Results: All the patients were acute onset; all were with vertigo, with ataxia gait in 16 cases, with nausea and vomiting in 13 cases, tinnitus, with hearing loss in 7 cases, with horizontal nystagmus in 5 cases, unilateral ocular motility disorders in 3 cases, facial paralysis in 3 cases, Horner syndrome in 3 cases, and limb paralysis in 1 case. The first CT was negative in 13 cases and follow-up CT showed the low density of the pontine brachium. Cranial MRI showed the pontine brachium with low signal in T1WI, high signal in T2WI, FLAIR and DWI, low signal in ADC. Unilateral involved in 16 cases and bilateral involved in 10 cases. The acute infarctions of other areas of posterior circulation were showed clearly on MRI. Conclusion: The clinical manifestations of acute pontine infarction are complex and diverse, and most of them are characterized by the damage manifestations of vestibular nerve and cerebellum. Imaging examination, especially timely MRI examination is helpful for diagnosis and differential diagnosis.