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目的：提示临床医生对椎－基底动脉缺血以发作性眩晕为主的老年患者，如反复发作或发作每次持续时间＞１小时，要考虑脑干梗死的形成。方法：分析３０例椎－基底动脉缺血以发作性眩晕为表现的患者临床特点及磁共振成像（ＭＲＩ）表现。结果：患者平均年龄＞６０岁，６例每日发作１次，每次发作持续时间＞１小时，２４例为每日反复发作≥５次，每次发作持续５～２０分钟，无神经系统阳性体征。头颅ＭＲＩ检查前全部患者临床诊断为椎－基底动脉缺血发作，头颅ＭＲＩ检查后确诊为脑干梗死。结论：对于单纯表现为发作性眩晕，特别是年龄＞６０岁的患者，眩晕每日反复发作≥５次或每次持续时间＞１小时，要高度怀疑脑干梗死的形成。
OBJECTIVE: To prompt clinicians to consider the incidence of brainstem infarction in elderly patients with predominant vertigo of vertebrobasilar ischemia, such as recurrent episodes or episodes lasting> 1 hour each. Methods: The clinical features and magnetic resonance imaging (MRI) findings of 30 patients with vertebrobasilar ischemia manifesting as episodic vertigo were analyzed. Results: The average age of patients> 60 years old, 6 cases of 1 episode per day, duration of each episode> 1 hour, 24 cases of repeated episodes per day ≥ 5 times, each attack lasted for 5 to 20 minutes, no neurological positive Signs. All patients before craniocerebral MRI diagnosis of clinical diagnosis of vertebrobasilar ischemia, head MRI diagnosis of brain stem infarction. CONCLUSIONS: Patients with episodes of vertigo, especially those> 60 years of age, should be highly suspicious of brain stem infarction for ≥5 consecutive episodes of vertigo or> 1 hour for each duration of dizziness.