小脑梗塞误诊为美尼尔病2例

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例1 女,60岁,农民。因发作性头昏、视物旋转、恶心、呕吐、耳鸣2h住院。体检:血压14.5/10.5kPa,神清,双侧眼球轻度水平震颤,双瞳孔等大等圆,对光反射灵敏。颈软无抵抗,四肢肌力、肌张力正常,生理反射存在,巴彬斯基征阴性。诊断美尼尔病。给予抗美尼尔合剂治疗。因眩晕进行性加重,入院第2天再次体检时发现指鼻试验阳性,经头颅CT扫描确诊为小脑梗塞。改用20%甘露醇、脉通液治疗后痊愈出院。例2 女,65岁,农民。因头痛、眩晕、恶心、呕吐1h住院。体检:血压14.5/9.5kPa,神清,双侧眼球水平性震颤,双瞳孔正大等圆,对光反射灵敏。四肢肌力、肌张力正常,生理反射存在,巴彬斯基征阴性。诊断美尼尔病。给予抗美尼尔合剂治疗。因头痛、头晕、呕吐加重,于入院第3天行神经系 Example 1 Female, 60 years old, farmer. Due to episodes of dizziness, depending on the material rotation, nausea, vomiting, tinnitus 2h hospitalization. Physical examination: blood pressure 14.5 / 10.5kPa, Shen Qing, mild bilateral tremor tremor, double pupil and other large round, sensitive to light reflection. Neck soft non-resistance, limb muscle strength, muscle tone normal, there is physiological reflex, Babinski sign negative. Diagnosis of Meniere’s disease. Give anti-Meniere mixture treatment. Because of vertigo progressive aggravating, admitted to hospital the second day again physical examination found that finger nasal test was positive, confirmed by skull CT scan of cerebellar infarction. Switch to 20% mannitol, pulse-fluid treatment cured. Example 2 Female, 65 years old, farmer. Due to headache, dizziness, nausea, vomiting 1h hospitalization. Physical examination: blood pressure 14.5 / 9.5kPa, Shen Qing, bilateral parietal tremor, double pupil Chia Tai and other round, sensitive to light reflection. Limb muscle strength, muscle tone normal, there is physiological reflex, Babinski sign negative. Diagnosis of Meniere’s disease. Give anti-Meniere mixture treatment. Due to headache, dizziness, vomiting increased, on the 3rd day of admission line of the nervous system
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