摘要
目的研究后循环脑梗死的影像学表现、病因、危险因素、临床表现、责任病灶及预后的特点。方法收集自2007年9月至2010年3月在我院住院治疗的53例后循环脑梗死病例的临床资料,总结患者的临床症状和体征,分析其影像学表现、病因和危险因素,根据Caplan使用的后循环供血区分段标准,将患者分为近段组、中段组、远段组、混合组四组。所有患者的预后均进行改良Rankin残障量表(mRs)评估,了解患者的预后情况。结果后循环梗死最常见的症状为眩晕28例(52.8%),恶心、呕吐23例(43.4%),肢体瘫痪21例(39.6%),言语不利17例(32.1%);最常见的体征是中枢性面舌瘫31例(58.5%),运动障碍21例(39.6%),感觉障碍17例(32.1%)及共济失调15例(28.3%);最常见的危险因素包括高血压、糖尿病、吸烟、饮酒、心脏病变、脂代谢异常。其中中段组发病率最高21例(39.6%),其次为远段组13例(24.5%),混合组10例(18.9%),近段组9例(17.0%)。根据mRS评估,34.0%的患者预后不良。结论后循环梗死的临床表现复杂多变,最常见的病变部位在中段,特征性临床表现和临床综合征有助于后循环脑梗死的诊断,大部分患者预后良好。
Objective To study the imaging characters, etiopathogenisis, risk factors, clinical manifestations, vascular lesions and prognosis of posterior circulation infarction. Methods Fifty-three patients with posterior circulation ischemic stroke were admitted to our department from September 2007 to March 2010 and they were analyzed retrospectively. All patients undertake magnetic resonance imaging（MRI） on admission and responsible lesions were identified in the posterior circulation territories. The patients＇ clinical symptoms and signs were evaluated and the relationships between lesion locations and clinical characteristics were analyzed. We subdivided the posterior circulation infarcts into proximal, middle, distal and mixed infarcts referring to NEMC-PCR study. The patients were evaluated by modified Rankin scale（mRS） to investigate the relationships between risk factors, lesion locations and prognosis. Results The common symptoms of posterior circulation ischemic stroke were vertigo（52.8%）, nausea and vomiting（43.4%）, limb paralysis（39.6%）, speech difficulty（32.1%）;the common signs of posterior circulation ischemic stroke were central facial or lingual palsy（58.5%）, limb weakness（39.6%）, limb sensory loss（32.1%）, ataxia（28.3%）. The most common risk factors were hypertension, diabetes, smoking, alcohol overuse, cardiopathy, hyperlipemia. The most common location of infarcts was in the middle segment（39.6%）, following by distal segment（24.5%）, mixed （18.9%） and proximal （17.0%）. About 34. 0% of cerebral infarction in posterior circulation have poor outcome referring to mRS. Conclusion The clinical features of patients with posterior circulation ischemic stroke were complex. Predominant symptoms can help to diagnose the posterior circulation ischemic stroke. The most common location of infarcts was in the middle segment. Majority of the patients with posterior circulation ischemic stroke have good prognosis.
出处
《中国卒中杂志》
2010年第9期730-734,共5页
Chinese Journal of Stroke
关键词
脑梗死
磁共振成像
症状和体征
Brain infarction
Magnetic resonance imaging
Symptoms ＆ signs
