Clinical analysis of misdiagnosed cases of posterior circulation cerebral infarction
CHEN Yong
LIU Hao
XIAO Liyan
Abstract：Objective To explore the clinical features,causes of misdiagnosis and preventive measures of posterior circulation cerebral infarction(POCI).Methods The clinical data of 4 patients with POCI who were misdiagnosed as having Meniere's disease from May 2021 to June 2023 were analyzed.Results All 4 patients in this group presented with vertigo as the chief complaint(3 patients with continuous vertigo and 1 patient with paroxysmal vertigo),accompanied by nausea and vomiting in 2 patients,unsteady gait in 2 patients,tinnitus in 3 patients,headache in 1 patient,and hearing impairment in 3 patients.All 4 patients were misdiagnosed as Meniere's disease,and the misdiagnosis lasted 3-6(4.34±1.06)d.After receiving symptomatic treatment,the clinical symptoms of the 4 patients in this group did not improve.After drug withdrawal,vertigo still recurred and worsened.After admission,based on detailed inquiry of the medical history and further completion of relevant examinations(head pulse-nystagmus-eye deviation test,head magnetic resonance angiography),combined with the characteristics of the disease and the examination results,it was finally diagnosed as POCI.Infarction site included pons in 2 patients,cerebellum in 1 patient and occipital lobe in 1 patient.After diagnosis,standardized symptomatic treatment was given,and the patient had a good outcome.During the 3-month follow-up after discharge,no sequelae occurred.Conclusion The symptoms of POCI are complex and diverse,and the positive rate of early imaging examinations is low,making it more likely to be misdiagnosed as Meniere's disease.Physicians conducting the initial diagnosis should enhance their ability to differentiate POCI,be familiar with the diagnostic process of vertigo diseases,complete relevant examinations,and achieve early diagnosis and early treatment,so as to reduce the occurrence of misdiagnosis of POCI.
Keywords：posterior circulation cerebral infarctionmisdiagnosisMeniere's diseasediagnosisvertigomagnetic resonance imaging
Publication Date：2025-08-28
Online Publishing Date：2025-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 16-19,41 )