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本文观察了44例中老年发作性眩晕的临床特点,分析、比较了他们和15例正常对照BAEP、TCD、脑SPECT的结果。发现A组(仅有发作性眩晕)多具有周围性眩晕的特点,而B组(以眩晕为突出表现的VBA-TIA)更具有中枢性眩晕的特点。两病例组BAEP的各项指标均延长,A组以Ⅰ-PL、Ⅰ-ⅢIPL延长为主,B组以Ⅰ-Ⅲ、Ⅲ-ⅤIPL延长为主;TCD发现两病例组VA、BA、PI-CA、PCA血流速度减低;A组以VA流速降低为甚,B组则以VA、PICA流速减低明显;脑SPECT显像显示两组在小脑、枕叶、基底节、颞枕区等区域血灌注减低。结合文献,本文讨论了中老年发作性眩晕的性质、机理。
In this paper, we observed the clinical features of 44 middle-aged and elderly patients with fulminant vertigo. We analyzed and compared the results of BAEP, TCD and brain SPECT in 15 normal controls. It was found that group A (episodic vertigo only) mostly had peripheral vertigo, whereas group B (VBA-TIA with prominent vertigo) had more central vertigo. The indexes of BAEP in both cases were prolonged. In group A, the prolongation of I-PL and I-IIIIPL was mainly in group B, and the prolongation of I-III and III-VIPL in group B was the predominant. In group A, VA, BA and PI- CA, PCA decreased blood flow velocity; A group to VA flow rate is even worse, B group with VA, PICA flow rate decreased significantly; SPECT imaging showed two groups in the cerebellum, occipital lobe, basal ganglia, temporal occipital and other regional blood Decreased perfusion. Combined with the literature, this article discusses the nature and mechanism of middle-aged and elderly onset of vertigo.