摘要
目的:探讨皮质下动脉硬化性脑病(Binswangerdisease,BD)的危险因素、临床特征及影像学改变。方法:回顾性分析26例BD住院患者的临床资料和脑CT,MRI的影像变化。结果:①24例(92.3%)患者有5～35年不等的原发性高血压病史,8例(30.8%)有糖尿病史,长期高血压伴有糖尿病或伴有多年饮酒史、吸烟史者病情较重。②BD临床特征:进行性加重的智能衰退,定向力障碍及人格改变,假性延髓麻痹征,锥体系及锥体外系损害的表现。③脑CT及MRI特点:白质疏松和深部白质的小梗死,表现为双侧侧脑室周围包括半卵圆中心对称性慢性缺血病灶,从侧脑室后角及前角向外方延伸,呈毛糙状边缘不清,侧脑室对称性扩大,同时可伴有基底核-内囊区、脑干的腔隙梗死。结论:原发性高血压是BD最重要的危险因素。对有长期高血压和进展性痴呆,伴有多发性腔隙性梗死者,结合脑CT及MRI改变可诊断为BD,及时合理的治疗可延缓病程。
AIM:To investigate the risk factors, clinical features and image changes of CT and MRI of Binswanger disease(BD). METHODS:The clinical files and cerebral CT and MRI changes of 26 BD inpatients were analyzed retrospectively. RESULTS:①There were 24 cases(92.3%) of the patients with the 5 to 35-year history of hypertension,and 8 cases(30.8%) with the history of diabetes.The state of BD was more severe in the patients with long-term hypertension accompanied by diabetes or long history of drinking and smoking.②The clinical features of BD was gradual decline of brainpower,orientation obstacle,characteristic changes, pseudobulbar palsy,manifestation of pyramidal and extrapyramidal motor system damages.③Features of CT and MRI was white matter loosening,small infarctions in deep white matter,manifested as bilateral ventricles including centrum semiovale around symmetric chronic ischemic lesions with rough obscure edges,extending outward from posterior and anterior horns,accompanied by symmetric enlarged lateral ventricles,as well as lacuna infarctions in basal ganglia-internal capsule area and brain-stem. CONCLUSION:Hypertension is the most important risk factor for BD.Patients with long-term hypertension and progressive dementia,who were accompanied by multiple lacuna infarctions, together with according image changes of CT and MRI,can be diagnosed to have BD,and then reasonable treatment can postpone the disease course.
出处
《中国临床康复》
CAS
CSCD
2004年第31期6950-6951,共2页
Chinese Journal of Clinical Rehabilitation
