摘要
目的探讨成人缺血型烟雾病的诊断要点及误漏诊原因。方法对我院2008年6月—2012年10月收治的25例误漏诊的成人烟雾病临床资料进行回顾性分析。结果本组8例因头痛误诊为血管性头痛;6例因视力障碍、眩晕误诊为后循环短暂性脑缺血发作;4例因癫痫发作且头颅MRI未见异常而误诊为特发性癫痫;4例因记忆力下降分别误诊为多发性脑梗死、脑白质病变;3例因反复晕厥发作未明确诊断。本组均经磁共振动脉造影(MRA)或数字减影血管造影(DSA)检查确诊为缺血型烟雾病,14例行硬脑膜动脉血管融通术治疗,11例予内科治疗,症状均有不同程度缓解。结论成人缺血型烟雾病临床症状复杂,头颅CT及MRI检查无特异性改变,但经颅多普勒超声可提示颅内血管狭窄,MRA及DSA为确诊手段。
Objective To analyze the key points of diagnosis and missed diagnosis or misdiagnosed causes of ischemic-type moyamoya disease （MMD） in adults. Methods Clinical data of 25 patients with MMD who were misdiagnosed or missed diagnosis during August 2008 and October 2012 was retrospectively analyzed. Results Eight patients were misdiagnosed as having vascular headache for headache, 6 patients as having posterior circulation transient ischemic attack （TIA） for visual disorder and dizziness, 4 patients as having epilepsia genuina for normal head magnetic resonance imaging （ MRI）, 4 patients as having multiple cerebral infarction or leukoencephalopathy for memory disorder, and 3 patients with repeat syncope was not definitely diagnosed. All patients were confirmed as having ischemic-type MMD by MR angiography （MRA） or digital subtraction angiography （DSA） examination. A total of 14 patients underwent encephaloduro-arterio-synangiosis （EDAS）, and 11 patients received medical treatment. All patients were relieved of symptoms in different degrees after curative intervention. Conclusion The clinical symptoms of MMD in adults are complicated although were complex, may CT or MRI may be normal in some patients. But transcranial Doppler sonography can show cerebrovascular stenosis, and MRA and DSA are preferred in confirming MMD.
出处
《临床误诊误治》
2013年第10期18-19,共2页
Clinical Misdiagnosis & Mistherapy
关键词
烟雾病
误诊
血管性头痛
脑缺血发作
短暂性
Moyamoya disease
Misdiagnosis
Vascular headache
Ischemic attack, transient
