Conjugate eye deviation on MRI and posterior circulation ischemic stroke presenting as isolated acute vestibular syndrome
10.3760/cma.j.issn.1673-4165.2024.11.006
- VernacularTitle:MRI显示的共轭性眼偏斜与表现为孤立性急性前庭综合征的后循环缺血性卒中
- Author:
Xiaohong QIAO
1
;
Yanbin CONG
;
Xu ZHANG
;
Fuhao ZHENG
Author Information
1. 青岛大学附属威海市中心医院神经内科，威海 264400
- Keywords:
Ischemic stroke;
Vertebrobasilar insufficiency;
Vestibular diseases;
Eye movements;
Cerebellar diseases;
Magnetic resonance imaging
- From:
International Journal of Cerebrovascular Diseases
2024;32(11):832-838
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the distribution characteristics of conjugate eye deviation on MRI in patients with posterior circulation ischemic stroke (PCIS) presenting as isolated acute vestibular syndrome (AVS), and its relationship with infarct lesions.Methods:Patients with PCIS presenting as isolated AVS admitted to Weihai Central Hospital Affiliated to Qingdao University from January 2022 to June 2024 were included retrospectively. The infarct distribution and eye deviation were detected by MRI within 3 days of admission. If the gaze deviation of both eyes horizontally towards the same side is observed, it was defined as radiological conjugate eye deviation (RCED); if one eye was deviated while the other eye was not; it was defined as radiological non-conjugate eye deviation (RDED). Multivariate logistic regression analysis was to determine the independent influencing factors of RCED. Results:A total of 82 patients with PCIS presenting with isolated AVS were included. Among them, there were 61 males (74.4%), mean aged 66.20±12.50 (range, 31-91) years. Seventy-two patients (87.8%) had cerebellar infarction, 9 (11.0%) had medullary infarction, 2 (2.4%) had caudal pontine infarction, 1 had both cerebellar and medullary infarction. MRI revealed RCED in 42 cases (51.2%), RDED in 22 cases (26.8%), and no deviation in 18 cases (22.0%). Of the 42 patients with RCED, 32 had cerebellar infarction, accounting for 44.4% of all patients with cerebellar infarction; there were 2 patients with caudal pontine infarction and 9 with medullary infarction. All 22 patients with RDED had cerebellar infarction. Univariate analysis showed that there was significant difference between the RCED group and the non-RCED group in age and the proportion of patients with lesions involving the cerebellar hemisphere and medullary infarction (all P<0.05). Multivariate logistic regression analysis showed that the lesion involvement in the cerebellar hemisphere was an independent influencing factor for RCED (odds ratio 0.169, 95% confidence interval 0.033-0.876; P=0.034). Conclusions:Cerebellar infarction is the most common in patients with PCIS presenting as isolated AVS. Both patients with medullary infarction and pontine infarction present with RCED, while the incidence of RCED in patients with cerebellar infarction is 44.4%. RDED is only seen in patients with cerebellar infarction. Compared with RCED, RDED is more common in patients with infarction involving the cerebellar hemisphere.
