摘要
目的探讨肢体抖动型短暂性脑缺血发作(limb-shaking transient ischemic attack,LS-TIA)的临床表现、影像学特征,降低漏诊率及误诊率,优化诊疗,降低缺血性脑血管病事件的发生。方法收集2016年3月—2017年7月我院神经内科收治的9例LS-TIA患者的临床资料(记录临床表现、影像学特征、治疗方法及随诊结果)进行回顾性分析。结果 9例患者存在颅内、颅外动脉狭窄或闭塞,所有患者均接受抗血小板聚集、强化降脂治疗,3例进行扩容治疗,4例进行血管内支架成形术治疗,余5例拒绝血管重建治疗,所有患者在出院时临床症状治愈。在随诊时,1例患者在半年后罹患左侧半球内分水岭脑梗死,1例患者在1年后罹患右侧半球内分水岭脑梗死,其余患者症状未再发作。结论 LS-TIA表现为肢体抖动,具有短暂性、刻板性、反复发作性特点,伴或不伴肢体力弱,且多数存在抖动肢体对侧颅内、外动脉狭窄或闭塞,经规范的脑血管病2级预防治疗及血管重建治疗,效果显著,可降低缺血性脑血管病事件的发生。
Objective To investigate the clinical manifestations and imaging features of limb-shaking transient ischemic attack,and reduce the rate of missed diagnosis and misdiagnosis,aiming at better diagnosis and treatment as well as lower incidence of ischemic cerebrovascular diseases.Methods Clinical data were collected from 9 patients with LS-TIA from March 2016 to July 2017 in our department of neurology(recording their clinical manifestations,imaging features,treatment methods and follow-up results)and a retrospective analysis was carried out accordingly.Results There were 9 cases of patients with intracranial and extracranial artery stenosis or occlusion.All of them received antiplatelet aggregation and intensive lipidlowering therapy.3 cases were given expansion treatment,4 cases were given percutaneous translu-minal angioplasty,and the rest 5 cases refused revascularization.All patients'clinical symptoms were disappeared when leaving the hospital.During follow-up clinic,one patient suffered from cerebral infarction in the divide of left hemisphere half a year later,and one patient suffered the same symptom in the right hemisphere after a year.The other patients had no symptoms.Conclusion LS-TIA is demonstrated as limb shaking,featuring by short,rigid and recurrent attack,with or without physical weakness of limbs.In most cases,there are intracranial and extracranial artery stenosis or occlusion in the contralateral hemisphere contrasting to the shaking limb.Through level 2 prevention and treatment for cerebrovascular diseases and therapy of revascularization,it can reduce the occurrence of ischemic cerebrovascular diseases.
作者
李志超
LI Zhichao(Department of Neurology,Second Hospital of Chifeng City,Chifeng Inner Mongolia 024000,China)
出处
《中国卫生标准管理》
2018年第15期35-38,共4页
China Health Standard Management
关键词
肢体抖动
短暂性脑缺血发作
癫痫
血液灌注
脑动脉病变
治疗
limb-shaking
transient ischemic attack
epilepsy
hemoperfusion
cerebral artery lesions
treatment
