临床表现为进展性脑卒中的胼胝体梗死八例分析  

Clinical analysis of 8 patients with corpus callosal infarction manifested as progressive ischemic stroke

作　　者：曹树刚[1] 徐文安[1] 夏明武[1] 赵昊[1] 吴倩[1] 王建[1] 葛婷婷[1] 

机构地区：[1]安徽医科大学附属合肥医院神经内科,230011

出　　处：《中华老年心脑血管病杂志》2013年第10期1057-1061,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨表现为进展性脑卒中胼胝体梗死患者的临床及影像学特点。方法收集经头颅MRI证实为胼胝体梗死患者23例，8例患者符合进展性脑卒中病程经过，分析其临床及影像学特点。结果发生进展性脑卒中的胼胝体梗死患者占所有胼胝体梗死患者的34．8％。主要危险因素有高血压、糖尿病、冠心病、高脂血症等。8例患者分别于发病后7～56h内出现进展，其中24h内进展4例，发病后56h进展1例，其余3例于发病后24～48h内进展，病情恶化突出的表现为偏侧肢体瘫痪加重，以下肢为主。8例患者均合并相邻部位梗死，累及扣带回6例，额叶及顶叶各4例，枕叶1例，侧脑室旁1例。磁共振血管造影显示，大脑前动脉狭窄6例，大脑前动脉闭塞2例，大脑后动脉狭窄2例，其中6例合并其他部位的血管病变。结论临床表现为进展性脑卒中的胼胝体梗死患者病情恶化多出现于发病后24h内，主要为偏侧肢体瘫痪加重，头颅MRI检查能及时明确梗死部位及相应血管病变。Objective To study the clinical and imaging features of patients with corpus callosal in- farction manifested as progressive isehemic stroke. Methods Clinical and imaging features of 23 patients with cranial MRI-confirmed corpus callosal infarction （including 8 manifestated as pro- gressive ischemic stroke） were analyzed. Results The patients with corpus callosal infarction manifested as progressive ischemic stroke accounted for 34.8%of the total patients included in this study. Hypertension,diabetes, coronary heart disease （CHD） and hyperlipoidemia were the major risk factors for progressive ischemic stroke. Of the 8 patients with corpus caIlosal infarction manifested as progressive ischemic stroke 7--56 h after onset of the disease,4 developed progres- sive ischemic stroke within 24 h after onset of the disease, 1 developed progressive ischemic stroke on day 3 after onset of the disease,and 3 developed progressive ischemic stroke 24--48 h after on- set of the disease. Paralysis of unilateral limb,especially the lower limbs,was exacerbated. Among the 8 patients with adjacent ischemic stroke, cingulate gyrus was involved in 6, frontal and parietal lobes were involved in 4,occipital lobe was involved in 1 and periventricular area was involved in 1. Magnetic resonance angiography showed anterior cerebral artery stenosis in 6 patients,anterior cerebral artery occlusion in 2 patients, and posterior cerebral artery stenosis in 2 patients, inclu- ding 6 patients with other eerebrovascular lesions. Conclusion The condition of patients with cor- pus eallosal infarction manifested as progressive ischemic stroke, especially as unilateral limb pa- ralysis,is exacerbated within 24 h after onset of the disease. Head MRI can accurately locate the ischemic stroke and its corresponding vascular lesions.

关 键 词：卒中 胼胝体 磁共振成像 高血压 冠心病 高脂血症 偏瘫 早期诊断 

分 类 号：R743.33[医药卫生—神经病学与精神病学]