急性孤立性头晕/眩晕起病的青年小脑梗死患者临床特点分析
Clinical analysis of young patients with cerebellar infarction starting with acute isolated dizziness/vertigo

赵媛.急性孤立性头晕/眩晕起病的青年小脑梗死患者临床特点分析[J].内科急危重症杂志,2026,32(3):237-239

DOI：10.11768/nkjwzzzz20260306

英文关键词:Young cerebellar infarction Isolated dizziness Diffusion- weighted imaging Influencing factors

基金项目:

作者	单位	E-mail
赵媛	北京市顺义区医院神经内科	zhangmei5389@126.com

摘要点击次数: 124

全文下载次数: 80

中文摘要:

摘要目的: 分析以孤立性头晕、眩晕为临床表现的急性青年小脑梗死患者的临床特点。方法：收集急性青年小脑梗死患者以及同时期住院的年龄相匹配的磁共振（MRI）-弥散性加权成像（DWI）阴性周围性头晕/眩晕患者的临床数据，分为急性小脑梗死组和周围头晕/眩晕组，分析2组患者的临床资料。结果：共纳入206例患者，急性青年小脑梗死组42例（20.4%），周围性眩晕/头晕组164例（79.6%）。单因素分析提示2组在性别、糖尿病、吸烟史、NLR比值、神经元特异性烯醇化酶(NSE)、持续头颈痛、持续性眼震、头脉冲-眼震-眼偏斜检查(HINTS)阳性、多发腔隙灶、椎动脉发育不全、椎-基底动脉扩张延长比较，差异有统计学意义（P均＜0.05）；多因素回归分析显示既往卒中史、糖尿病、椎-基底动脉扩张延长是青年小脑梗死的独立危险因素（P均＜0.05）。大动脉粥样硬化仍是最常见病因，心源性栓塞和动脉夹层较常见。结论：急性头晕/眩晕且合并糖尿病、既往有卒中病史和椎-基底动脉扩张延长的患者，需尽早完善MRI-DWI检查，识别有无急性小脑梗死，以尽早诊治。

英文摘要:

Abstract Objective: To analyze the clinical characteristics of young patients with acute cerebellar infarction presenting with isolated dizziness and vertigo. Methods: The clinical data of patients with acute young cerebellar infarction and age-matched patients with diffusion-weighted imaging (DWI)-negative peripheral dizziness/vertigo hospitalized during the same period were collected and divided into an acute cerebellar infarction group and a peripheral dizziness/vertigo group. The clinical characteristics of the two groups were then analyzed. Results: A total of 206 patients were included, with 42 (20.4%) in the acute young cerebellar infarction group and 164 (79.6%) in the peripheral vertigo/dizziness group. Univariate analysis indicated statistically significant differences between the two groups in terms of gender, diabetes mellitus, smoking history, NLR, NSE, persistent head and neck pain, persistent nystagmus, positive HINTS test, multiple lacunar foci, vertebral arter hypoplasia, and vertebrobasilar dolichoectasia (P< 0.05). Multivariate regression analysis revealed that a history of stroke, diabetes mellitus, and vertebrobasilar dolichoectasia were independent risk factors for cerebellar infarction in young patients (P< 0.05). Atherosclerosis remained the most common etiology, while cardiac embolism and arterial dissection were also frequently observed. Conclusion: Young patients presenting with acute dizziness/vertigo, especially those with diabetes mellitus, a history of stroke, or vertebrobasilar artery ectasia, should undergo prompt MRI-DWI to identify acute cerebellar infarction and facilitate early intervention.