脑桥心形梗死(附4例报告及文献复习)  

“White Heart”in Bilateral Pontine Infarction:Four Cases Report and Review Literature

作　　者：魏丽 邢婷婷 任海兵 陈利平 白青科[1] 魏文石 刘赞华 赵晓晖[1] WEI Li;XING Ting-ting;REN Hai-bing;CHEN Li-ping;BAI Qing-ke;WEI Wen-shi;LIU Zhan-hua;ZHAO Xiao-hui(Department of Neurology,Shanghai Pudong New Area People’s Hospital,Shanghai 201200,China;Department of Neurology,Huadong Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]上海市浦东新区人民医院神经内科,上海201200 [2]复旦大学附属华东医院神经内科,上海200040

出　　处：《中国临床神经科学》2024年第2期182-186,共5页Chinese Journal of Clinical Neurosciences

基　　金：上海市浦东新区卫生健康委员会优秀青年医学人才培养计划(编号:PWRq2021-37);上海市浦东新区卫生健康委员会重点学科建设项目(编号:PWZxk2022-23)。

摘　　要：目的报道4例脑桥心形梗死病例的临床资料供借鉴。方法回顾性分析收治的4例脑桥心形梗死患者临床资料,并复习相关文献进行分析总结。结果4例患者中3例就诊时为昏迷状态,另1例患者r-tPA静脉溶栓治疗后仍快速进展至昏迷。4例患者均经MRI检查证实为脑桥心形梗死,其中3例经DSA证实为基底动脉中段闭塞,并采取静脉溶栓联合血管取栓治疗。预后分别为:1例支架取栓后预后良好;1例抽吸治疗预后良好;1例经球囊扩张、支架取栓、支架植入术,术后为闭锁综合征,目前仍康复治疗中;1例家属放弃静脉溶栓及血管内治疗,最终死亡。结论脑桥心形梗死是一种特殊类型的后循环恶性脑梗死,预后差,需要早期积极干预治疗。Aim To report clinical data of 4 cases of“white heart”in bilateral pontine infarction for reference.Methods The 4 patients of“white heart”in bilateral pontine infarction were retrospectively analyzed,and the relevant literature was reviewed for analysis and summary.Results Among the 4 patients,3 patients showed coma at the time of consultation,while the other patients rapidly progressed to coma after r-tPA intravenous thrombolysis treatment.These 4 patients were all confirmed as“white heart”pontine infarction by MRI.Three patients were confirmed as middle segment occlusion of basilar artery by DSA,and were treated with intravenous thrombolysis combined with vascular thrombectomy.The prognosis of the 3 patients were as follows:1 patient had a good prognosis after stent thrombectomy,1 patient had a good prognosis after aspiration treatment,and 1 patient was still in locked-in syndrome after balloon dilatation,stent thrombectomy,and stent implantation.She was still in rehabilitation treatment.Another patient ultimately ended in death due to his family abandoning intravenous thrombolysis and intravascular treatment.Conclusion“White heart”in pontine infarction is a special type of posterior circulation infarction with poor prognosis and requires early active intervention and treatment.

关 键 词：脑桥梗死 脑桥心形梗死 急性脑梗死 

分 类 号：R743[医药卫生—神经病学与精神病学]