双侧大脑前动脉闭塞1例报告并文献复习  

Bilateral anterior cerebral artery occlusion(report of 1 case and review of literature)

作　　者：徐修鹏[1] 常晗晓 赵鹏展 李海林[1] 季晶[1] 刘宁[1] 路华[1] XU Xiu-peng;CHANG Han-xiao;ZHAO Peng-zhan;LU Hua(Department of Neurosurgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院神经外科,南京210029

出　　处：《临床神经外科杂志》2020年第5期598-600,共3页Journal of Clinical Neurosurgery

基　　金：国家自然科学基金资助项目(81872058)。

摘　　要：目的探讨双侧大脑前动脉闭塞的流行病学特征、发病机制、临床表现及预后。方法回顾性分析南京医科大学第一附属医院2018年12月收治的1例双侧大脑前动脉闭塞患者的临床资料,并复习相关文献。结果本例患者男性,62岁,有高血压、糖尿病、脑缺血发作史;主要表现为四肢无力、运动性缄默伴小便失禁;头颅CT检查示右侧脑室前角及胼胝体膝部脑梗死,DSA及MRA检查确诊为双侧大脑前动脉闭塞。经内科保守治疗及康复锻炼,患者双下肢无力及小便失禁无好转。结论双侧大脑前动脉闭塞病例非常罕见,容易误诊为其他疾病,发病机制尚不明确;影像学检查是其主要的确诊方法;应尽早明确诊断,早期治疗,以改善患者的预后。Objective To explore the epidemiological features,pathogenesis,clinical manifestations,and prognosis of bilateral anterior cerebral artery occlusion.Methods The clinical data of a patient with bilateral anterior cerebral artery occlusion was analyzed retrospectively and the literature was reviewed.Results A 62 year old male presented with history of hypertension,diabetes and cerebral ischemia.The main manifestations were weakness of limbs,motor mutism and urinary incontinence.Cerebral CT showed cerebral infarction in the right anterior horn of ventricle and genu callosum.DSA and MRA confirmed bilateral anterior cerebral artery occlusion.After conservative treatment and rehabilitation exercise,the patient's lower limbs weakness and urinary incontinence did not improve.Conclusions Bilateral anterior cerebral artery occlusion cases are very rare and easy to be misdiagnosed as other diseases.The pathogenesis is not clear.The imaging examination is the main method of diagnosis.Early diagnosis and early treatment should be made to improve the prognosis of patients.

关 键 词：大脑前动脉 闭塞 脑梗死 发病机制 诊断 

分 类 号：R651[医药卫生—外科学] R543.5[医药卫生—临床医学]