应当对无卒中症状的腔隙性脑梗死病灶或白质脱髓鞘进行恰当诊治  

Appropriate diagnosis and treatment for lacunar infarcts and leukoaraiosis without stroke symptoms

作　　者：徐芒芒[1] 刘鸣[1] XU Mangmang;LIU Ming(Department of Neurology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院神经内科,成都610041

出　　处：《华西医学》2022年第6期801-805,共5页West China Medical Journal

基　　金：国家自然科学基金(82001250);中国博士后科学基金(2020M683322,2021T140488);四川大学华西医院学科发展1·3·5工程项目(ZYGD18009)。

摘　　要：缺血灶、腔隙性脑梗死病灶、白质脱髓鞘等描述常出现在有头晕、头痛等非特异性症状患者或健康体检人群的头部CT或MRI检查报告中。这些影像表现虽多与血管病变特别是脑小血管病相关,但并不代表都需要长期服用抗血小板药物和他汀类药物。在复习文献和总结临床经验的基础上,该文指出针对这类表现的处理方法包括确定是否为血管源性病变,寻找是否存在高龄、高血压、糖尿病、血管狭窄、心理因素等危险因素或病因,并进行相应防治,为临床上对这些影像表现的恰当诊治提出了参考意见。Ischemic lesions,lacunar infarcts and leukoaraiosis on head CT or MRI are commonly detected in patients with non-specific symptoms such as dizziness and headache or people undergoing healthy physical examinations.Although these imaging findings are mostly related to vascular disease,especially cerebral small vessel disease,it does not mean that long-term use of antiplatelet drugs and statins are required.On the basis of literature review and clinical experiences,the article points out that the treatment methods for such manifestations include determining whether these lesions are vascular lesions,searching for risk factors or causes such as aging,hypertension,diabetes mellitus,vascular stenosis,and psychological factors,and taking strategies for the corresponding prevention and management,provides a reference for the appropriate diagnosis and treatment of these imaging manifestations in clinical practice.

关 键 词：缺血灶 腔隙性脑梗死 白质脱髓鞘 脑小血管病 

分 类 号：R743.3[医药卫生—神经病学与精神病学]