肢体抖动型短暂性脑缺血发作合并锁骨下动脉盗血综合征一例并文献复习  

A case report and literature review of limb-shaking transient ischemic attacks with subclavian steal syndrome

作　　者：赵筱汐 马欣[1] Zhao Xiaoxi;Ma Xin(Department of Neurology,Xuanwu Hospital,Capital Medical University,National Clinical Research Center for Geriatric Diseases,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经内科国家老年疾病临床医学研究中心,北京100053

出　　处：《中国脑血管病杂志》2021年第11期790-793,共4页Chinese Journal of Cerebrovascular Diseases

摘　　要：肢体抖动型短暂性脑缺血发作(LS-TIA)作为TIA的特殊类型,主要表现为一侧肢体或单肢短暂的颤动、抖动、扭动等不自主运动,常由患肢对侧前循环责任动脉重度狭窄或闭塞造成。作者报道了1例合并锁骨下动脉盗血综合征的LS-TIA患者,该患者表现为发作性左侧肢体抖动。头颈动脉存在多发性狭窄,其中右侧大脑前动脉A2段闭塞,双侧大脑中动脉轻至中度狭窄,右侧锁骨下动脉重度狭窄、完全型盗血,CT灌注成像显示右侧大脑前动脉、大脑中动脉供血区灌注减低。患者临床表现与血管狭窄程度不完全相符,作者分析其非典型诱因导致的血流动力学改变所造成的相关影响,并结合文献进行综述,以期为LS-TIA诊治提供新的思路。Limb-shaking transient ischemic attack(LS-TIA),a special type of TIA,is mainly manifested as brief,coarse and involuntary movement of ipsilateral limbs or a single limb,such as tremor,shaking and twisting.Severe stenosis or occlusion of the opposite anterior circulation artery is always responsible for the affected limbs.The authors reported a case of LS-TIA with subclavian artery steal syndrome.The initial complaint of the patient was paroxysmal shaking of the left limbs.There were multiple stenosis of his cervicocephalic arteries,including occlusion of A2 segment of right anterior cerebral artery,mild to moderate stenosis of bilateral middle cerebral arteries,and severe stenosis of the right subclavian artery with completely reversed blood flow.CT perfusion imaging showed decreased perfusion in the blood supply area of the right anterior cerebral artery and the right middle cerebral artery.The clinical manifestations of this patient were not completely consistent with the degree of vascular stenosis.This case report analyzed the related effects of hemodynamic changes caused by atypical inducement and reviewed previous literatures in order to provide new perspective for diagnosis and treatment of LS-TIA.

关 键 词：脑缺血发作 短暂性 锁骨下动脉窃血综合征 肢体抖动 

分 类 号：R743.31[医药卫生—神经病学与精神病学]