动脉源性和血液因素导致的脑梗死:洛桑经验和文献回顾(法国)  

Cerebral infarction of arterial origin and hae-matological causation: The Lausanne experience and a review of the literature (Fren)

作　　者：Gonthier A. Bogousslavsky J. 雷翀 

机构地区：[1]Departement de Medecine Interne, C HUV, rue du Bugnon 46, 1011 Lausanne, Switzerland

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第5期48-49,共2页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Introduction. Hematological diseases are seldom found as the etiology of isch emic strokes, but are frequently investigated by expensive laboratory tests afte r a first cerebral vascular event. Methods. In the Lausanne Stroke Registry, we retrospectively reviewed the cases of patients hospitalized between 1979 and 2001 for a first is chemic arterial stroke which was attributed to a hematological etiology. Of 4697 patients, 22 (0.47 per cent) had a stroke due to one of the following hematolog ical pathology: polycythemia vera (4), secondary polycythemia (4), essential thr ombocytemia (2), secondary thrombocytosis (4), multiple myeloma (1), CIVD (1), p rotein S deficiency (1), antiphospholipid antibody syndrome (4), moderate homocy steinemia (1). A literature review was undertaken for each hemopathy. Conclusion . In light of the results of these data, we concluded that a complete blood coun t provides sufficient hematological screening for the majority of patients hospi talized for an arterial stroke. The antiphospholipid antibody syndrome is a rare cause of cerebral infarction, which needs to be investigated in young patients, in cases of multiple or recurring stroke or in the presence of a typical histor y. Inherited thrombophilias are not a significant risk factor for arterial cereb ral infarction and their investigation is only warranted for a sub-group of yo ung patients with a cryptogenic stroke, in which group the prevalence is slightl y increased. Moderate homocysteinemia must be considered as a cerebrovascular ri sk factor of minor importance, but potentially treatable by a substitution of vi tamin B 12, B 6 and folates. The efficacy of this substitution in the prevention of cardiovascular events needs vet to be demonstrated.Introduction. Hematological diseases are seldom found as the etiology of isch emic strokes, but are frequently investigated by expensive laboratory tests afte r a first cerebral vascular event. Methods. In the Lausanne Stroke Registry, we retrospectively reviewed the cases of patients hospitalized between 1979 and 2001 for a first is chemic arterial stroke which was attributed to a hematological etiology. Of 4697 patients, 22 (0.47 per cent) had a stroke due to one of the following hematolog ical pathology: polycythemia vera (4), secondary polycythemia (4), essential thr ombocytemia (2), secondary thrombocytosis (4), multiple myeloma (1), CIVD (1), p rotein S deficiency (1), antiphospholipid antibody syndrome (4), moderate homocy steinemia (1). A literature review was undertaken for each hemopathy. Conclusion . In light of the results of these data, we concluded that a complete blood coun t provides sufficient hematological screening for the majority of patients hospi talized for an arterial stroke. The antiphospholipid antibody syndrome is a rare cause of cerebral infarction, which needs to be investigated in young patients, in cases of multiple or recurring stroke or in the presence of a typical histor y. Inherited thrombophilias are not a significant risk factor for arterial cereb ral infarction and their investigation is only warranted for a sub-group of yo ung patients with a cryptogenic stroke, in which group the prevalence is slightl y increased. Moderate homocysteinemia must be considered as a cerebrovascular ri sk factor of minor importance, but potentially treatable by a substitution of vi tamin B 12, B 6 and folates. The efficacy of this substitution in the prevention of cardiovascular events needs vet to be demonstrated.

关 键 词：文献回顾 缺血性卒中 复发性卒中 心血管事件 亚组 血管危险因素 缺乏症 典型病史 血小板增多症 全血细胞计数 

分 类 号：R743.33[医药卫生—神经病学与精神病学]