Percheron动脉闭塞致双侧丘脑梗死临床及影像学特征分析  

Assessment of the clinical and imaging features of patients with bilateral thalamic infarction caused by occlusion of the artery of Percheron

作　　者：王立志[1] 罗伟良[1] 刘武[1] 李博生[1] 代海洋[2] WANG Lizhi;LUO Weiliang;LIU Wu;LI Bosheng;DAI Haiyang(Department of Neurology,Huizhou Municipal Central Hospital,Huizhou 516001,China)

机构地区：[1]惠州市中心人民医院神经内科,广东惠州516001 [2]惠州市中心人民医院放射科,广东惠州516001

出　　处：《实用医学杂志》2020年第4期553-556,共4页The Journal of Practical Medicine

基　　金：广东省医学科研基金项目(编号:A2015536)。

摘　　要：目的探讨Percheron动脉梗死的临床及影像学特征。方法分析9例Percheron动脉梗死患者的临床表现、影像学资料、治疗及预后。结果9例患者均急性起病,6例以意识障碍为首发症状,主要临床表现为意识障碍6例,记忆力下降5例,眼球垂直凝视麻痹4例,失语3例,肢体无力5例。头颅MRI DWI序列均显示双侧丘脑旁正中部蝶翼状高信号,5例合并中脑上部受累,2例可见中脑"V"字征。9例患者出院时均病情好转,6例患者出院后3个月预后良好(mRS评分≤2分)。结论Percheron动脉梗死临床少见,临床表现以意识障碍、垂直凝视麻痹、记忆力下降为主,头颅MRI表现为双侧丘脑旁正中部DWI序列高信号改变,伴或不伴中脑受累。早期识别并给予积极溶栓治疗,可显著改善患者预后。Objective To assess the clinical and imaging features of patients with the artery of Percheron infarction.Methods The clinical symptoms,images,treatment and prognosis of 9 patients with a Percheron infarction were analyzed.Results All 9 patients had acute onset.The initial symptom of 6 patients was consciousness disorder.The clinical presentation included consciousness disorder(n=6),memory impairment(n=5),vertical gaze palsy(n=4),aphasia(n=3),limb weakness(n=5).MRI showed symmetrical hyperintensity on diffusion-weighted imaging(DW1)in bilateral paramedian thalamus in 9 patients,and 5 patients had rostral midbrain involvement.V-shaped sign in midbrain in 2 patients was observed.All 9 patients were improved and discharged.There were 6 patients with a favorable outcome(mRS≤2)at 3 months.Conclusions The artery of Percheron infarction is rare in clinical practice.The classical clinical symptoms include consciousness disorder,vertical gaze palsy and memory impairment.The hyperintensity on DWI in bilateral paramedian thalamus with or without midbrain involvement is the characteristic performance of MRI.Early recognition and active thrombolysis therapy subsequently can improve the prognosis of the patients with artery of Percheron infarction.

关 键 词：脑梗死 丘脑 Percheron动脉 磁共振成像 临床表现 影像学表现 

分 类 号：R445.2[医药卫生—影像医学与核医学]