脑梗死致同侧肢体无力8例临床和影像分析  

Clinical and imaging analysis of 8 cases with ipsilateral hemiparesis in ischemic stroke

作　　者：伍嫦珠[1] 陈龙 WU Changzhu;CHEN Long(Taizhou Hospital of Zhejiang Province,Taizhou 317000,China)

机构地区：[1]浙江省台州医院,浙江台州317000 [2]临海市第一人民医院,浙江台州317000

出　　处：《中风与神经疾病杂志》2022年第5期405-408,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的总结脑梗死导致同侧肢体无力病例的临床及影像学特点,并探讨可能的病生理机制。方法收集了2016年1月1日-2020年12月30日在我科住院的急性脑梗死导致同侧肢体无力患者的临床资料,对患者的神经系统症状体征、核磁共振成像(magnetic resonance imaging,MRI)等检查结果等进行描述性分析。结果在4495例急性脑梗死患者中共发现8例同侧肢体偏瘫病例(占0.18%),所有患者均为腔隙性脑梗死,4例有既往脑梗死病史,3例在对侧脑区有陈旧软化灶,1例患者DTI提示锥体束未交叉,2例病灶在脑干,2例在半卵圆中心,3例在内囊,1例在壳核,1例在额叶皮质。结论脑梗死导致同侧肢体无力患者多有既往锥体束损伤史,多为腔隙性病灶,部位多位于同侧锥体束走形区。Objective To summarize the clinical and imaging features of ipsilateral limb weakness caused by cerebral infarction,and to explore the possible physiological mechanism of the disease.Methods The clinical data of patients with ipside-limb weakness caused by acute cerebral infarction hospitalized in our department from January 1,2016 to December 30,2016 were collected,and the neurological symptoms and signs,magnetic resonance imaging(MRI)and other examination results of the patients were analyzed descriptively.Results 8 cases of ipsilateral hemiparesis(0.18%)were found in 4495 patients with acute cerebral infarction,all 8 patients were lacunar cerebral infarction,4 cases with previous medical history of cerebral infarction,3 cases have old infarcts in Contralateral cerebral hemisphere,DTI of 1 case showed pyramidal tract was not cross,the lesions of 2 cases were in the brain stem,2 cases in centrum semiovale,3 cases in capsule,One was in the putamen and one in the frontal cortex.Conclusion Most of the patients with ipside hemiparesis caused by cerebral infarction had a history of previous pyramidal tract injury,which was mostly lacunar lesions,mostly located in the configuration area of ipside-pyramidal tract.

关 键 词：脑梗死 同侧肢体无力 同侧偏瘫 锥体束交叉 

分 类 号：R743[医药卫生—神经病学与精神病学]