曾敏　　刘洋　　龚细礼

[关键词] 孤立性眩晕;后循环缺血;发生机制;危险因素

[中图分类号] R743.3          [文獻标识码] A          [文章编号] 1673-9701（2021）20-0184-04

Research progress on the mechanism of occurrence and risk factors of posterior circulation ischemic isolated vertigo

ZENG Min1   LIU Yang2   GONG Xili1

1.Department of Neurology，Xiangdong Hospital Affiliated to Hunan Normal University，Liling   412200，China; 2.Department of Critical Care Medicine，Xiangdong Hospital Affiliated to Hunan Normal University，Liling   412200，China

[Abstract] Vertigo is a common symptom in the department of neurology.The causes of vertigo are numerous and complex.Distinguish central and peripheral damages in time is the key to diagnose and treat vertigo.Isolated vertigo is characterized by paroxysmal or persistent vertigo，which may be accompanied by autonomic neurological dysfunction，but has no symptoms and signs of focal neurological deficit.In recent years，clinical researchers have found that isolated vertigo can be the only manifestation of posterior circulation ischemia，which is difficult to be diagnosed clinically.However，early identification of central vertigo is very important for clinical diagnosis，treatment and prognosis.In this paper，the mechanism and related risk factors of posterior circulation ischemic isolated vertigo are reviewed.It is hoped to improve the identification rate of posterior circulation ischemic isolated vertigo.

[Key words] Isolated vertigo; Posterior circulation ischemia; Occurrence mechanism; Risk factors

眩晕是一种造成人与周围环境的空间关系在大脑皮质中反应失真，产生旋转、倾倒、起伏等感觉的运动性或者位置性的错觉，是神经内科最常见的症状之一。导致眩晕的病因繁多复杂[1]，依据病变部位和不同的临床表现分为周围性眩晕和中枢性眩晕，临床上早期识别中枢性和周围性的病因是诊断与治疗眩晕及影响其临床预后的关键。目前临床上有多个研究报道发现中枢性眩晕可表现为单一的眩晕症状而无神经系统受损的相关症状及体征[1-3]，早期与周围性眩晕难以区分，这类眩晕被称为孤立性眩晕。孤立性眩晕是指患者表现为发作性或持续性眩晕，可伴有恶心呕吐、多汗、心慌等自主神经功能紊乱症状，但是缺乏局灶性神经系统功能缺损的症状及体征如肢体的麻木、乏力、面部麻木、言语障碍等以及听力受损等[5-6]。由于孤立性眩晕临床表现不典型，病因隐匿，早期与周围性眩晕鉴别困难，目前在临床上越来越引起临床医师的重视[7-8]。本文通过学习近年来相关文献，对后循环缺血性孤立性眩晕的发生机制及其相关危险因素进行综述，希望为提高临床工作中眩晕患者中枢性眩晕的诊断率以及为及时有效地治疗、改善患者临床预后提供一些帮助。

1 后循环缺血性孤立性眩晕

近年来有关孤立性眩晕为后循环……