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目的 :探讨Wallenberg综合征病因、临床表现及CT、MRI改变。方法 :分析 1992～ 1998年住院诊断为Wallenberg综合征 17例病人病因 ,临床表现 ,CT与MRI改变。结果 :Wallenberg综合征病因主要为小脑后下动脉缺血所致 ,但也有出血性疾病。临床主要表现为 :病灶侧软腭声带麻痹 ,咽反射消失 ( 94 1% ) ,病灶侧面部及对侧痛温觉障碍 ( 88 2 % ) ,病灶同侧Horner征( 82 4 % ) ,病灶同侧小脑性共济失调 ( 70 6% ) ,眩晕 ( 70 6% ) ,恶心、呕吐 ( 58 8% ) ,水平眼震 ( 52 9% ) ,头痛 ( 2 3 5% ) ,呃逆 ( 17 6% ) ,病灶对侧肢体轻瘫 ( 11 8% )。 17例病人发病 72h内行头部CT扫描 ,1例发现延髓有出血 ,另 16例延髓无异常改变。发病 72h内头部MRI检查 ,9例延髓有异常信号改变 ,5例小脑有异常信号改变 ,2例基底节区有异常信号改变。结论 :Wallenberg是一组多病因综合征。MRI检查优于CT ,但并不是所有Wallenberg综合征MRI检查均有阳性发现。
Objective: To investigate the etiology, clinical manifestations, CT and MRI changes of Wallenberg syndrome. Methods: The etiology, clinical manifestations, CT and MRI changes of 17 patients diagnosed as Wallenberg syndrome from 1992 to 1998 were analyzed. Results: The etiology of Wallenberg syndrome was mainly due to ischemia of cerebellar inferior cerebellar artery, but also hemorrhagic disease. Clinical manifestations were as follows: soft palate vocal cord paralysis on the lesion side, disappearance of pharyngeal reflex (94 1%), temperature sensation (88 2%) on the side of the lesion and contralateral pain, Horner’s lesion ipsilateral (82 4%), Cerebellar ataxia (70.6%), dizziness (70.6%), nausea and vomiting (58.8%), nystagmus level (52.9%), headache (23.5% , Contralateral limb paralysis (11 8%). Seventeen patients underwent CT scans within 72 hours after onset of symptoms. One patient had bleeding in the medulla oblongata and the other 16 patients had no abnormal changes in the medulla oblongata. Within 72 hours after the onset of head MRI examination, 9 cases of medullary abnormal signal changes, 5 cases of cerebellar abnormal signal changes, 2 cases of basal ganglia abnormal signal changes. Conclusion: Wallenberg is a group of multiple etiological syndromes. MRI is superior to CT, but not all Wallenberg syndrome MRI findings are positive.