摘要
目的根据头颅MRI对脑桥梗死病灶的定位,结合脑桥的解剖学特点,探讨脑桥梗死临床表现的特点。方法50例急性脑桥梗死均行头颅MRI检查,并对其病灶位置分布、神经系统体征、神经功能缺损程度(MRS评分)等指标进行分析。结果按头颅MRI横轴位上的病灶位置,50例脑桥梗死病例中:腹内侧梗死占48%,腹外侧梗死占32%,被盖部梗死占12%,双侧梗死占8%。在临床表现特点上,腹内、外侧梗死多表现为病灶对侧肢体偏瘫、中枢性面瘫以及构音障碍,同时伴或不伴肢体共济失调;脑桥被盖部梗死主要表现为脑神经瘫痪及感觉障碍;双侧脑桥梗死则往往表现为假性延髓性麻痹、双侧肢体运动障碍。腹内、外侧梗死起病后30 d MRS评分值较入院时明显改善(P<0.01),双侧脑桥梗死MRS评分值较其余各组高。结论脑桥梗死病灶多位于腹侧,且多表现为病灶对侧肢体瘫痪、中枢性面瘫以及构音障碍;脑桥梗死预后总体较好,不同梗死部位范围影响神经功能缺失程度。
Objective To study the clinical features of pontine infarction with the results of MRI and the anatomy feature.Methods We observed 50 acute pontine infarctions and paid attention to the lesion distribution,nerve system signs and general disability status.Results Based on the lesion distribution,50 pontine infarction cases could be classified into ventromedial(48%),ventrolateral(32%),tegmental(12%) and bilateral infarctions(8%).Ventromedial and ventrolateral infarcts lead to contralateral brachio-crural hemiparesis,central facial paresis and dysathria,also with or without brachio-crural ataxia.Isolated tegmental infarcts were associated to cranial nerve palsy and sense disturbances,with mild motor deficits.Bilateral infarction involved the bilateral pyramidal tracts and tegmentum,represents pseudobulbar palsy and bilateral motor deficits.General disability status and outcome: MRS score of 30 d after onset was distinctly better than admission in ventral groups(P<0.01),bilateral group had the worst MRS score.Conclusion The ventral lesions is most common for pontine infarctions.Pontine infarctions often present as contralateral brachio-crural hemiparesis,central facial paresis and dysathria.The degree of disability status is corresponding to the leision site.
出处
《中国实用神经疾病杂志》
2010年第3期3-7,共5页
Chinese Journal of Practical Nervous Diseases
