内囊预警综合征六例  

Clinical analysis in six patients with capsular warning syndrome

作　　者：苏凡凡[1] 刘辉[1] 王利萍[1] 杜卫[1] 

机构地区：[1]大连市解放军第210医院神经内科,辽宁116021

出　　处：《脑与神经疾病杂志》2016年第4期247-251,共5页Journal of Brain and Nervous Diseases

摘　　要：目的分析内囊预警综合征(CWS)患者的临床特征和影像学表现,并探讨其发病机制。方法分析2008年7月至2014年10月本院收治的6例CWS患者的临床资料。结果患者均有卒中危险因素,其中高血压6例、高脂血症1例、高尿酸1例及有吸烟史4例。入院时ABCD2评分均在4~5分之间。于首次发作后第1~6天患者出现4~14次(平均8次)短暂性运动或运动感觉症状发作,持续时间30s^90min,平均17min。发作后1例患者无任何症状体征及DWI异常,2例患者无体征,但DWI显示有急性病灶,余3例患者残留体征及DWI异常。内囊梗死4例,丘脑梗死1例。DSA或CTA、MRA检查未发现大动脉狭窄。联合治疗效果欠佳。结论 CWS主要损害中央运动通路,其发病机制仍不十分清楚,可能与深穿支动脉粥样硬化、血流动力学改变有关。Objective To explore the pathophysiology of capsular warning syndrome （CWS） by the clinical manifestations and imaging characteristics of 6 cases.Methods Between July 2008 and Oct 2014, six patients were studied retrospectively. Results All the patients had vascular risks：6 had hypertention, 1 had hyperlipiemia, 1 had hyperuricemia,4 were smokers. ABCD2 scores were 4-5 on admission. Six patients presented with 4-14 motor or sensorimotor transient ischemic attacks （TIA） lasting from 30 seconds to 90 minutes up to 6 days after onset of the first episode.One patient had TIA only ,whereas 5 patients subsequently developed s stroke ,which were demonstrated on DW1.The DWI lesions was localized to the thalamus in 1 patient, and to the internal capsual in other 4 patients. Transfemoral cerebral angiography examination were performed in 4 patients, while cervial and intracranial CT angiography（CTA） examinations were performed in 1 patient, magnetic resonance angiography（MRA） was performed in the other patient. There were no significant abnormal findings. Combined therapies seemed to be ineffective. Conclusion The primary lesion in CWS is close to central motor pathways.The pathophysiology of CWS is complex and unkonwn.h may involve hemodynamic mechanisms in penetrating arterial territories.

关 键 词：内囊预警综合征 短暂性 脑缺血发作 

分 类 号：R243.32[医药卫生—中医临床基础]