【突发性感音神经性听力损失合并急性脑梗死的临床特点】。

H Y Li, Y Wang, Y P Tong, M Y Zhang, Y Ju, Y Xia
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摘要

目的:分析突发性感音神经性耳聋合并急性脑梗死患者的临床及影像学特征,为早期识别此类疾病提供依据。方法:采用病例系列报告研究。回顾性分析2017年1月至2021年12月在北京天坛医院耳鼻喉头颈外科就诊并经MRI-DWI诊断为急性脑梗死的29例突发性听力损失(SHL)患者的临床及影像学资料。结果:患者年龄31 ~ 71岁,平均年龄56±12岁,男性占82.8%(24/29)。82.8%(24/29)的患者有3种及以上的动脉粥样硬化危险因素,24.1%(7/29)的患者有SHL病史。听力类型为平坦型和全聋:86.2%(25/29)的患者有重度听力损失,27.6%(8/29)的患者有双侧SHL, 17.2%(5/29)的患者在住院期间有进一步的听力损失,82.8%(24/29)的患者在发病时有头晕或眩晕。中枢神经系统受累的症状主要包括语言障碍、复视、吞咽困难、中枢性面瘫、面肢感觉减退、共济失调和肌力下降。影像学评价显示21例位于后循环供应区,8例位于前循环供应区。82.8%(24/29)的患者存在椎基底动脉狭窄,58.6%(17/29)的患者存在严重的椎基底动脉狭窄或闭塞。结论:SHL进展为脑梗死的患者通常有多种动脉粥样硬化危险因素和SHL。患者多为中老年男性,常主诉头晕或头晕伴单侧或双侧SHL的严重扁平和全聋。影像学结果提示大多数患者有后循环梗塞,常伴有椎基底动脉严重狭窄或闭塞。
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[Clinical characteristics of sudden sensorineural hearing loss with acute cerebral infarction].

Objective: To analyze the clinical and imaging features of patients with sudden sensorineural deafness and acute cerebral infarction in order to provide evidence for early recognition of such diseases. Methods: This was a case series reporting study. A retrospective analysis was performed on the clinical and imaging data of 29 patients with sudden hearing loss (SHL) who admitted to the Otolaryngology Head and Neck Surgery Department of Beijing Tiantan Hospital from January 2017 to December 2021 and diagnosed with acute cerebral infarction using MRI-DWI. Results: The patients were aged 31-71 years, with an average age of 56±12 years, and 82.8% (24/29) were men. In total, 82.8% (24/29) of the patients had three or more atherosclerotic risk factors, and 24.1% (7/29) had a history of SHL. The hearing types were flat and total deafness: 86.2% (25/29) of the patients had severe hearing loss, 27.6% (8/29) had bilateral SHL, 17.2% (5/29) had further hearing loss during hospitalization, and 82.8% (24/29) had dizziness or vertigo at the onset. The signs of central nervous system involvement mainly included speech impairment, diplopia, dysphagia, central facial paralysis, facial and limb hypoesthesia, ataxia, and decreased muscle strength. Imaging evaluation showed that 21 cases were located in the posterior circulation supply area and 8 cases in the anterior circulation supply area. Additionally, 82.8% (24/29) patients had vertebrobasilar artery stenosis, and 58.6% (17/29) patients had severe vertebrobasilar artery stenosis or occlusion. Conclusions: Patients with SHL who progress to cerebral infarction often have multiple atherosclerotic risk factors and SHL. Most of the patients are middle-aged and older men who often complain of dizziness or dizziness accompanied by severe flat and total deafness with unilateral or bilateral SHL. Imaging findings suggest that most patients have posterior circulation infarction, often accompanied by severe stenosis or occlusion of the vertebrobasilar artery.

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