フリーラジカル消去剤エダラボン投与が著効を示した急性期小脳・脳幹梗塞めまい症例

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  • Two cases where the free radical scavenger edaravone therapy was effective against acute brainstem and cerebellar infarction with vertigo

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We report on 2 cases where edaravone (radicut®) was effective against acute brainstem and cerebellar infarction with vertigo. Patient 1 was a 74-year-old woman who had hypertension and presented with sudden vertigo. When she was admitted to our hospital, she had dysarthria and left hemiplegia. MRI performed on the first day and 3 days later did not show any abnormal regions. MRI performed 10 days later showed an abnormal region in the right ventrolateral medulla oblongata. Edaravone treatment was effective for her brainstem infarction. Patient 2 was a 50-year-old man who experienced sudden attacks of vertigo. Gaze nystagmus towards the left was noted. Head CT yielded normal results. Pure-tone audiometry showed profound right-sided sensorineural hearing loss. Initially, we considered that the patient had sudden deafness with vertigo, but he developed dysarthria after admission. Therefore, MRI was performed and showed a cerebellar infarction in the territory of the anterior inferior cerebellar artery. The patient was finally diagnosed as having anterior inferior cerebellar artery (AICA) syndrome. Therapy with edaravone, a free radical scavenger, was effective not only against cerebellar infarction but also against sudden hearing loss. MRI is essential for final confirmation of the diagnosis in such cases. However, sometimes, it does not show any definite abnormalities in the case of hyperacute brainstem and cerebellar infarction. We therefore consider neuro-otological examinations - in particular nystagmus assessment - as very valuable tools for clinical diagnosis in such cases.

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