《头晕》视频文字版(该视频中dizziness“头晕”实际指眩晕)(显著病史)、PhysicalExam(体格检查)、BenignVSEmergent(良性VS急性)、WhentoImage(何时行影像学检查)、Treatment(处理)BenignVSEmergent良性VS急性NOTcentralVSperipheral—plex现已不再区分中枢性及外周性,因其太复杂。IschemicposteriorCVAorbleedistheemergency!!后循环缺血性卒中或出血是急性的。While25%ofCVApresentswithdizziness,%ofdizzinessEDvisitsareforCVA/TIA虽有25%的卒中患者出现头晕,%头晕急诊患者被诊为卒中/短暂性脑缺血发作。8迷路与第Ⅷ对脑神经Labyrinth:3semicircularcanalsandotoliths:ule迷路:三个半规管及含有耳石的椭圆囊和球囊。8(vestibularandcochlearnerves)冲动由迷路传入第Ⅷ对脑神经(前庭蜗神经)CentralPathophysiology中枢病理生理Brainstem脑干:vestibularnucleiinmedullaandpons延髓和脑桥之前庭神经核Cerebellum小脑(因其处密闭空间,须觅良法查之)Othercontributingfactorstodizziness其他对头晕起作用之因素Spinalcordimpulses脊神经冲动(后角感觉外周感觉)Occipitallobeimpulses枕叶冲动(视觉相关)DizzinessDefinition头晕分类Vertigo=AcuteVestibularSyndrome眩晕=急性前庭综合征Vertigo:motion,disorientationinspace眩晕:动性或位置性错觉Presyncope:diaphoresis,abouttofaintorpassout,seeingstars昏厥前期表现:出汗,欲倒,眼冒金星Disequilibrium:difficultystandingupright,assocwithperiphneuopathy前兆:难以直立,(没有摔倒而感觉可能摔倒,恶心),伴随有外周神经病。anic,fatigue/tired虚弱状态:可为器官性,疲乏/劳累History:DeadlyD’s Diplopia复视Dysarthria构音障碍Dysphasia言语障碍Dysphonia发声困难Dysaesthesia感觉不良Dropattackswithoutsyncope无昏厥的摔倒发作Down-is-updistortions(roomtilting)上下颠倒式感觉失真(房间倾斜)(如有上述症状,需要治疗)AcuteVestibularSyndrome:Whentoworry?急性前庭症状:何时予以关切?Multipleprodromalepisodes多次前驱症状发作(患者自觉即将发生眩晕)aitdisturbance异常的呕吐或步态障碍Headacheorneckpain头痛或颈
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