胼胝体梗死：临床与影像学特征  

Corpus callosum infarction： clinical and imaging features

作　　者：盛蕾[1] 胡丹[1] 肖婧[1] 张兰坤[1] 胡君[2] 王立[3] 李传游[1] 丁彩霞[1] 江雪梅[1] 汤银燕[1] 朱羽佳[1] 姜寒[1] 凌志香[1] 杨小燕[1] 

机构地区：[1]南京中医药大学第二附属医院,江苏省第二中医院脑病科,210017 [2]南京脑科医院放射科,210029 [3]南京脑科医院神经内科,210029

出　　处：《国际脑血管病杂志》2013年第7期536-540,共5页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨胼胝体梗死患者的临床和影像学特征。方法回顾性收集经颅脑M刚证实的胼胝体梗死患者，对其临床表现和影像学资料进行分析。结果胼胝体梗死占所有脑梗死患者的1．04％（7／671），其主要危险因素是高血压、冠心病和糖尿病。典型表现包括观念运动性失用（42．9％）、额叶步态（28．6％）和异己手综合征（14．3％），可伴有肢体瘫痪、意识障碍和认知损害等症状。MRI共检出胼胝体病灶8个，以体部多见（62．5％），其次为压部（25．0％）和膝部（1愿，12．5％）。额叶（57．1％）、基底节区（42．9％）和枕叶（42．9％）常同时被累及。弥散张量成像显示，1例患者胼胝体体部和膝部纤维连接中断。6例患者血管造影显示血管狭窄或闭塞，其中以椎动脉狭窄最多见（66．7％），其次为大脑前动脉（50．0％），颈总动脉、颈内动脉和大脑中动脉较少见（均为33．3％）。结论胼胝体梗死发生率低，动脉粥样硬化是致病关键，其临床表现多样，与梗死部位有关。Objective To investigate the clinical and imaging features in patients with corpus callosum infarction. Methods The patients with corpus callosum infarction confirmed by MRI were collected retrospectively. Their clinical manifestations and imaging data were analyzed. Results The corpus callosum infarction accounted for 1.04% of all patients with cerebral infarction. Its major risk factors were hypertension, coronary heart disease, and diabetes. Its typical clinical manifestations included ideomotor apraxia （42. 9% ）, frontal gait （28. 6%） and alien hand syndrome （14. 3%） accompanied with limb paralysis, disturbance of consciousness, cognitive impairment and other symptoms. MRI detected 8 corpus callosum lesions. Most were involved in the body of corpus callosum （62. 5% ）, followed by splenium （25.0%） and genu （1/8, 12. 5% ）. The frontal lobe （57. 1% ）, basal antglia （42. 9% ） and occipital lobe （42. 9% ） were frequently involved. Diffusion tensor imaging revealed that the fiber connections of the body and genu of corpus callosum were broken in one case. Angiography showed that 6 patients had vascular stenosis or occlusion, and the most common was vertebral artery stenosis （66. 7% ）, followed by anterior cerebral artery （50. 0% ）, and common carotid artery, internal carotid artery and middle cerebral artery stenoses were rare （all 33.3% ）. Conclusions The incidence of corpus callosum infarction is low. Atherosclerosis is the pathogenic key. Its clinical manifestations are diverse, and they are associated with the sites of infarction.

关 键 词：脑梗死 胼胝体 磁共振成像 

分 类 号：R743.3[医药卫生—神经病学与精神病学]