臨床急性前庭障害と誤った小脳梗塞の2例

概要

論文の詳細を見る
We report on two cases of cerebellar infarction which were thought to be examples of acute vestibular disorder before being diagnosed with MRI. Case 1: A 44-year-old man, who had vertigo and nausea, showed right-beating spontaneous and positional nystagmus. As he could not get up from bed at all after admission, caloric testing and rotational testing were performed. These tests did not show canal paresis and the visual suppression test was normal. After that, MRI was performed and showed cerebellar vermis infarction without brain stem involvement which was thought to be in the PICA (posterior inferior cerebellar artery) area. A paleocerebellum lesion showing only truncal ataxia and no neuro-otological abnormalities, was thought to be responsible for the symptom. Case 2: A 71-year-old man, referred to our hospital with vertigo and bilateral hearing loss, showed right-beating spontaneous nystagmus. Finger-nose testing and diadochokinesia were normal and truncal ataxia did not appear. Though MRI was performed to rule out an acoustic neuroma, it showed cerebellar infarction without brain stem involvement which was thought to be in the SCA (superior cerebellar artery) area. Cases of acute-onset vertigo or dizziness, including vestibular neuritis, must not be diagnosed without examining the true origin of the symptoms.