数字减影脑血管造影术对伴发眩晕的后循环缺血患者血管异常病因分析

目的 通过数字减影脑血管造影术(DSA)对伴发眩晕的后循环缺血(PCI)患者的头颈部血管进行检查,分析其血管异常病因,掌握其发病规律.方法 对138例伴发眩晕的PCI患者入院后给予详细的影像学检查,包括MRI、DSA,分析患者血管异常与PCI的因果关系.结果 138例患者,诊断为椎基底动脉系统短暂性缺血发作者89例、椎基底动脉系统脑梗死49例,综合所有的影像学检查结果分析,椎基底动脉血管异常者86例,考虑与PCI病因有关,有12例患者明确有心脏痛心房颤动,考虑与后循环脑梗死病因有关,其余40例患者病因不明确.结论伴发眩晕的PCI患者的血管异常病因为:①椎基底动脉系统血管变异;②椎基底动脉系统血管狭窄或闭塞导致的后循环出现低灌注状态或脑梗死.

Etiology of vascular anomalies in patients with posterior circulation ischemia associated with vertigo by digital subtraction angiography

Objective To inspect head and neck blood vessels of patients with posterior circulation ischemia （PCI） associated with vertigo by digital subtraction angiography（DSA）,and to analyze the causes of abnormal blood vessels in control of the occurrence. Methods 138 patients of PCI associated with vertigo were given detailed imaging check after admission,including magnetic resonance imaging（MRI）,DSA. The results were analyzed for the causality of PCI and vascular anomalies. Results In 138 patients, 89 cases were diagnosed as vertebrobasilar transient ischemic attack,and 49 cases were vertebrobasilar system cerebral infarction. The integrated analysis of all the imaging findings was that：the causes of 86 cases with PCI attributed to abnormal vertebral-basilar arteries,and the causes of 12 patients with posterior circulation cerebral infarction were considered to be related atrial fibrillation, and the causes of the remaining 40 patients were not clear. Conclusion In PCI patients associated with vertigo, the causes of vascular abnormalities were： ①vertebrobasilar vascular variation; ②hypoperfusion or cerebral infarction of the posterior circulation due to vertebrobasilar stenosis or occlusion.