急性脑干梗死76例临床分析  

Clinic analysis of seventy-six patients with acute brainstem infarction

作　　者：吕祥龙[1] 李鹏[1] 陈道文[2] 

机构地区：[1]安徽省滁州市中西医结合医院神经内科,239000 [2]南京医科大学附属脑科医院神经内科

出　　处：《卒中与神经疾病》2012年第4期211-213,共3页Stroke and Nervous Diseases

摘　　要：目的探讨脑干梗死的临床特征。方法回顾性分析76例急性脑干梗死患者的临床资料、影像学检查结果及治疗预后。结果本组平均年龄58岁,均急性起病。主要临床表现:肢体瘫痪62例(81.6%),感觉障碍35例(46.1%),眩晕34例(44.7%),构音障碍23例(30.3%),吞咽困难20例(26.3%),复视10例(13.2%),意识障碍3例(3.9%),动眼神经麻痹3例(3.9%),外展神经麻痹6例(7.9%),面瘫16例(21.1%),舌瘫28例(36.8%),共济失调21例(27.6%),真性球麻痹13例(17.1%),Horner征8例(10.5%),临床表现符合脑干常见综合征25例(32.9%);所有患者MRI检查均发现脑干急性梗死灶,中脑梗死7例(9.2%),桥脑梗死40例(52.6%),延髓梗死20例(26.3%),桥脑延髓交界部梗死9例(11.8%);本组治疗后显著进步36例(47.4%),进步27例(35.5%),无变化4例(5.3%),恶化5例(6.6%),死亡4例(5.3%)。结论脑干梗死临床表现多样,仅部分患者出现脑干交叉症状和体征,确诊依赖MRI检查,患者预后与梗死灶面积、部位及并发症有关。Objective TO explore the clinical characteristics of patients with acute brainstem infarction. Methods The clinical manifestation, imaging data and prognosis of 76 patients with acute brainstem infarction were reviewed. Results The average age of enrolled patients was 58 years old. All of them presented with a- cute onset. The main clinical presentation included paralysis of extremities （62 cases, 81.6%）, sensory dis- turbance （35 cases, 46. 1%）, vertigo （34 cases,44. 7%）, dysarthria （23 cases,30. 3%）, dysphagia（20 cases, 26. 3%） ,diplopia （10 eases, 13. 2%）, consciousness disorders （3 cases, 3.9$）, oculomotor palsy （3 eases, 3. 9%）, abducens paralysis （6 cases,7. 9$）, facial palsy （16 cases,21.1$）, lingual paralysis （28 cases, 36. 8%）, ataxia （21 eases, 27. 6%）, true hulbar palsy （13 cases, 17. 1%） and Horner syndrome （8 eases, 10. 5%）. The clinic manifestation of 25 cases （32. 9%） were consistent with common syndrome of brainstem. All of the patients received brain MRI examination and showed acute infarction in brainstemo The lesions loca- ted in rnesencephalon （7 cases, 9. 2$）, pons （40 cases, 52. 6$）, medulla （20 cases, 26. 3 $）, borderline of pons and medulla （9 cases, 1 1. 8）. Treatment effects included 36 cases （47. 4%） of significant improvement, 27 cases （35. 5~） of improvement, 4 cases （5. 3%） of no change, 5 cases （6. 6%） of aggravation and 4 cases of death （5. 3%）. Conelasions The patients of brainstem infarction present with a variety of clinical features and some of them show cross symptoms or signs. Magnetic resonance imaging is important in diagnosis of this disease. The prognosis of brainstem infarction is related with the area, location of infarction and occurrence of complications.

关 键 词：脑干梗死 临床表现 MRI检查 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]