目的 探讨青年Wallenberg综合征的临床特点.方法 回顾并分析20例青年Wallenberg综合征患者的临床资料.结果 本组患者平均年龄37岁,以急性(16例)或亚急性(4例)起病.主要临床表现为头痛13例(65％),眩晕伴或不伴恶心、呕吐、眼震15例(75％),吞咽困难、声音嘶哑13例(65％)；交叉型感觉障碍18例(90％),Horner征12例(60％),共济失调9例(45％),不同类型运动障碍9例(45％).20例头颅MRI均发现延髓梗死灶,行颈部MR血管成像检查的8例患者均发现椎动脉异常,其中左侧椎动脉细小2例,细小伴远端狭窄1例,左侧椎动脉迂曲1例,右侧椎动脉细小2例,狭窄2例.结论 除眩晕、延髓麻痹、交叉型感觉障碍、Horner征、共济失调经典表现外,头痛是青年Wallenberg综合征常见的临床症状；椎动脉异常可能与青年Wallenberg综合征发病有关.%Objective To explore the clinical characteristics of young patients with Wallenberg syndrome. Methods The clinical data of 20 young patients with Wallenberg syndrome were reviewed and analyzed. Results The average age of enrolled patients was 37 years old. The onset in 16 cases was acute and in 4 cases was subacute. The main clinical manifestations were headache (13 cases, 65% ), vertigo with or without nausea, vomiting and nystagmus (15 cases, 75%), dysphagia and/or hoarseness (13 cases, 65%), crossed sensory disturbance (18 cases, 90% ) , Homer's syndrome (12 cases, 60% ) , ataxia (9 cases, 45% ) and motor deficits (9 cases, 45% ). All of the 20 cases displayed infarct lesions in medulla by skull MRI examination. All of the 8 cases who received neck MR angiography (MRA) examination existed vertebral arteries abnormal, including extenuation of left vertebral artery in 2 cases, extenuation combined with distal stenosis of left vertebral artery in 1 case, circuity of left vertebral artery in 1 case, extenuation in 2 cases and stenosis in 2 cases of right vertebral artery. Conclusions Headache is one of common clinical symptoms except classic presentations ( vertigo, crossed sensory disturbance, bulboparalysis, Homer's syndrome and ataxia) in young patients with Wallenberg syndrome. Abnormity of vertebral artery may be related to the development of this disease.
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