摘要
目的:探讨胼胝体梗死患者的临床和影像学特征。方法:回顾性分析35例急性胼胝体梗死患者的临床及影像学资料。结果:35例胼胝体梗死患者,占全部脑梗死的2.8%(35/1 239),男21例,女14例,平均年龄64.5岁;合并高血压26例,高脂血症19例,吸烟史17例,糖尿病15例,既往明确脑梗死病史或影像学发现有陈旧梗死病灶者25例;其中21例以胼胝体为主要病灶的患者中肢体无力19例,语言功能障碍13例,认知功能障碍10例,偏身感觉障碍4例,失用3例,头晕、行走不稳3例,小便障碍2例,偏盲1例,意识障碍1例。头颅CT阳性率8.6%(3/35),核磁阳性率100%(33/33)。病灶分布:体部22例、膝部12例、压部12例、嘴部2例。单纯胼胝体梗死1例,其余34例患者均同时伴有其他部位急性梗死病灶。依据CISS病因学诊断:颅内外大动脉粥样硬化性脑梗死23例,心源性脑栓塞3例,穿支动脉疾病1例,病因不明8例。结论:胼胝体梗死好发于中老年人,其发病率较低,病灶特点以胼胝体的体部受累多见,常同时合并其他部位梗死,核磁阳性率远高于CT检查,典型的失连接综合征在临床中较为少见,主要病因为颅内外大动脉粥样硬化,且胼胝体梗死的发生提示患者的动脉粥样硬化已较为广泛而严重。
Objective:To investigate clinical and imaging features of patients with corpus callosal infarction. Methods:A ret-rospective analysis was conducted on the clinical and imaging data of 35 patients with corpus callosal infarction. Results:Of 1 239 pa-tients with ischemic stroke, 35 patients were diagnosed as acute corpus callosal infarction (2. 8%), including 21 males and 14 fe-males, 64. 5 years on average. Past history:26 cases with hypertension, 19 cases with hyperlipidemia, 17 cases with cigarette smok-ing, 15 cases with diabetes, 25 cases with cerebral infarction ( clinical or imaging) . Of 21 cases whose symptoms were caused mainly by corpus callosal infarction, 19 cases appeared limb weakness, 13 cases developed language disorder, 10 cases had disturbance of in-telligence, 4 cases had sensory disability, 3 cases had apraxia, 3 cases had dizziness and walking instability, 2 cases had urine disor-der, 1 case had hemianopsia and 1 case had conscious disturbance. The positive rate was 8. 5% (3/35) by CT scan and 100% (33/33) by MRI. The locations of corpus callosal infarction:22 cases at body area, 12 cases at genu, 12 cases at splenium and 2 cases at rostrum. There were 34 patients having other acute infarction lesions besides corpus callosum area, only 1 patient had pure corpus cal-losal infarction. Etiological diagnosis according to CISS ( Chinese ischemic stroke subclassification):23 cases diagnosed with intracra-nial and extracranial arteriosclerotic cerebral infarction, 3 cases with cardiogenic cerebral embolism, 1 case with perforating artery dis-ease, 8 cases with undetermined etiology. Conclusions:Corpus callosal infarction is happened mainly in middle-aged and aged people with lower incidence rate. The location of corpus callosal infarction is mostly at body area and the patients always have other acute in-farction lesions simultaneously. MRI is superior to CT scan in the diagnosis of corpus callosal infarction. Typical disconnection syn-drome is rarely seen in the clinic. Corpus callosal infarction is
出处
《中国民康医学》
2015年第6期13-15,18,共4页
Medical Journal of Chinese People’s Health
关键词
胼胝体梗死
动脉粥样硬化
失连接综合征
病因
发病率
Corpus callosal infarction
Arteriosclerosis
Disconnection syndrome
Etiology
Incidence rate
