Wallenberg综合征临床特点、CT与MRI

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年住院急诊为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％），眩晕（70．6％），恶心、呕吐（58．8％），水平眼震（52．9％）、头痛（23．5％）、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。

Clinical CT and MRI characteristics of wallenberg's syndrome

To investigate the pathogeny, clinical CT and MRI characteristics of Wallenberg s syndrom.Methods: 17 cases of wallenberg's syndrome were analysed who had received and diagnosed in our hospital from 1992 to1998. Results: The pathogeny of Wallenberg's syndrome mainly was caused by ischemia of the posterior inferior cere-bellar artery, but sometimes was caused by hemorrhage diseases. The clinical manifestations were observed: focal later-al vocal cords paralysis of soft palate, and gag reflex disappear (94.1% ), ipsilateral sensory (pain and heat) impair-ment of the face and contralateral else where (88.2%), focal ipsilateral Homer syndrome (82.4%), focal ipsilateralcerebeller ataxia (70.6%), vertigo (70.6%), nauseatation, vomit (58.8%), level nystagmus (52.9%),headache (23.5%), niccough(17.6%), focal contra lateral limbs paresis (11.8%). Swenteen patients were testedwith cranial CT scanning after occurrence in 72 hours, in which 1 case had medulla oblongata hemorrhage. Howeverwith MRI scanning 9 cases had abnormal signal change in medulla oblongata, 5 cases had abnormal signal change incerebellum, 2 cases had abnormal signal in basal ganglion. Conclusion: Wallenberg is a group of multipathogeny syn-dromo. MRI was better than CT, in diagnosis of the reasons of the syndrome.