摘要
目的分析内囊预警综合征(CWS)患者的临床特征和影像学表现,并探讨其病理生理机制。方法回顾性分析2008-07-2012-05作者医院收治的6例CWS患者的临床资料。结果患者均有脑卒中危险因素,其中有高血压病史6例,高血脂1例,高尿酸1例,有吸烟史4例。入院时ABCD2评分均在4～5分之间。于首次发作后第1～6天患者出现4～14次短暂性运动或运动感觉症状发作,持续时间30s～90min。发作后1例患者无任何症状体征及DWI异常,2例患者无体征但DWI显示有急性病灶,余3例患者残留体征及DWI异常。内囊梗死4例,丘脑梗死1例。DSA或CTA、MRA检查未发现大动脉狭窄。联合治疗效果不佳。结论 CWS主要损害中央运动通路,其发病病理生理机制复杂且仍不十分清楚,可能与深穿支动脉粥样硬化、血流动力学改变有关。
Objective To explore the pathophysiology of capsular warning syndrome （CWS） by the clinical manifestations and imaging characteristics of 6 cases.Methods Between July 2008 and May 2012,six patients were studied retrospectively.Results All the patients had vascular risks：6 had hypertension,1 had hyperlipidemia,1 had hyperuricemia,4 were smokers.ABCD2 scores were 4-5 on admission.Six patients presented with 4-14 motor or sensorimotor transient ischemic attacks （TIA） lasting from 30 seconds to 90 minutes up to 6 days after onset of the first episode.One patient had TIA only,whereas 5 patients subsequently developed a stroke,which were demonstrated on DWI.The DWI lesions was localized to the thalamus in 1 patient,and to the internal capsual in other 4 patients.Transfemoral cerebral angiography examination were performed in 4 patients,while cervial and intracranial CT angiography （CTA） examinations were performed in 1 patients,magnetic resonance angiography （MRA） was performed in the other patient.There were no significant abnormal findings.Combined therapies seemed to be ineffective.Conclusions The primary lesion in CWS is close to central motor pathways.The pathophysiology of CWS is complex and unknown.It may involve hemodynamic mechanisms in penetrating arterial territories.
出处
《中国神经免疫学和神经病学杂志》
CAS
北大核心
2013年第3期180-183,共4页
Chinese Journal of Neuroimmunology and Neurology
关键词
脑缺血发作
短暂性
内囊预警综合征
颅内动脉硬化
磁共振成像
弥散
ischemic attack, transient
capsular warning syndrome
intracranial arteriosclerosis
diffusion magnetic resonance imaging
