中枢血管性急性前庭综合征研究进展_谢溯江指南.pdfVIP

中华临床医师杂志(电子版)2013 年 10 月第 7 卷第 22 期 Chin J Clinicians(Electronic Edition),November 15,2013,Vol.7,No.22  ·10251 · ·综述· 中枢血管性急性前庭综合征研究进展 急性前庭综合征的主要特征是：急性发作的持续自发性眩晕（持续数天）、自发性眼震、姿 态不稳以及自主神经症状。外周性急性前庭综合征通常包括前庭神经炎、梅尼埃病等。由于椎基底动脉缺 血性卒中引起的中枢血管性急性前庭综合征，除了眩晕外，往往伴有其他神经功能障碍，但是中枢血管性 急性前庭综合征，特别是小脑卒中引起的眩晕，往往单独出现，与外周急性前庭综合征表现类似。近来大 样本回顾性研究发现：约 11%的孤立性小脑梗死患者只表现为孤立性的眩晕，与外周急性前庭综合征相似； 另外床边的头脉冲测试是鉴别中枢与外周急性前庭综合征最有效方法。本文对表现为孤立性眩晕或听觉前 庭丧失的中枢血管性急性前庭综合征的研究进展进行了综述，以促进其的临床鉴别诊断。 综述文献（主题）； 急性前庭综合征 Research advances in central cute vestibular syndrome of a vascular cause XIE Su-jiang, ZHENG Ying-juan, ZHANG Lin. Vestibular Function Laboratory, Institute of Aviation Medicine, Air Force, Beijing 100142, China Corresponding author: XIE Su-jiang, Email: sujiang_xie@ 【Abstract 】 Acute vestibular syndrome(AVS) is characterized by acute onset of spontaneous prolonged vertigo (lasting days), spontaneous nystagmus, postural instability, and autonomic symptoms. Peripheral AVS commonly presents as vestibular neuritis, but may also include other disorders such as Menieres disease. Vertigo in central AVS due to vertebrobasilar ischemic stroke is usually accompanied by other neurological dysfunction. However it can occur in isolation and mimicking peripheral AVS, particularly with cerebellar strokes. Recent large prospective studies have demonstrated that approximately 11% of patients with isolated cerebellar infarction presented with isolated vertigo mimicking peripheral AVS, and the bedside head impulse test is the most useful tool for differentiating central from peripheral AVS. Herein we review research advances in central AVS of a vascular cause presenting with isolated vertigo or audiovestibular loss in order to facilitate the