めまいを主訴とした脳血管障害例

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  • Acute Vertigo with Cerebrovascular Lesion

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Nineteen patients (12 males and 7 females, average age 61 years) of acute vertigo with cerebrovascular lesion were investigated retrospectively. All patients were finally diagnosed as vascular lesions in the posterior fossa, cerebellum or brainstem, 17 patients with infarction and 2 with hemorrhage. Of 19 patients, 11 were initially suspected of peripheral lesions and other 8 of central lesions.<BR>Twelve of 19 patients initially visited emergency unit of our institute and 12 patients visited Neuro-otology clinic initially or from the emergency unit, and 15 patients were admitted to Neuro-otology ward. Most patients who were initially suspected of peripherallesions visited emergency unit and were admitted to Neuro-otology ward directly.<BR>Neurological and neuro-otological symptoms and signs were slight at initial visit or on admission among patients initially suspected of peripheral lesions, though all patients were diagnosed as central lesion within a few days (mode 2 days).<BR>Diagnosis of central lesion were made mainly based on neurological, neurootological and MRI findings, and CT scans were not so useful except in patients with hemorrhage. Of neuro-otological examinations, the nystagmus test, eye movement tests and qualitative tests for pursuit and optokinetic nystagmus were most effective in the diagnosis of central lesion.

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