摘要
目的探讨脑干腹侧部中线旁对称性脑梗死综合征的临床特点。方法对11例脑干腹侧部中线旁对称性脑梗死患者的临床资料及影像学检查进行回顾性分析。比较7例孤立性脑干病灶与4例合并后循环其他部位病灶患者,6例老年与5例中青年患者的临床资料。结果患者均为急性起病,以不同程度的意识障碍、眼球运动障碍及四肢瘫痪为主要特点;病灶累及延髓1例,延髓脑桥交界区1例,单纯累及脑桥3例,同时累及中脑和脑桥4例,单纯累及中脑2例;3例死亡,3例持续性意识障碍,5例好转。孤立性脑干病灶与后循环多发病灶患者高脂血症、吸烟史和出院改良的Rankin量表≥4分比较,差异有统计学意义(P<0.05,P<0.01);老年患者意识障碍、合并肺感染、死亡或未愈比例较中青年患者高(P<0.05,P<0.01)。结论脑干腹侧部中线旁对称性脑梗死是椎基底动脉梗死的一种特殊类型,常见病因为椎基底动脉穿支闭塞,临床症状复杂多样,老年患者预后更差。
Objective To study the clinical and imaging characteristics of bilateral ischemic stroke on ventral median line of brain stem.Methods The clinical and imaging data of 11 patients with ischemic stroke on ventral median line of brain stem were retrospectively analyzed.The clinical data of 7isolated brain stem ischemic stroke patients and 4posterior circulation ischemic stroke patients,6elderly and 5middle-aged and young ischemic stroke patients were compared.ResultsThe patients were mainly manifested as acute onset of disease,disorder of consciousness,disorder of eye movement,and quadriplegia.Of the 11 patients included in this study,1was diagnosed with ischemic stroke in medulla,1 with ischemic stroke in pontomedullary junction,3 with ischemic stroke in pons,4with ischemic stroke both in pons and midbrain,2with ischemic stroke in midbrain.Of the 11 patients included in this study,3died,3had persistent disorder of consciousness,and 5 were improved.The history of hyperlipidemia and smoking was significantly longer,the NIHSS score on admission and the rate of poor outcome were significantly higher in isolated brain stem ischemic stroke patients with posterior circulation ischemic stroke（P〈0.05,P〈0.01）.The rate of disorder of consciousness,lung infection,poor coutcome was significantly higher in elderly ischemic stroke patients than in middle-aged and young ischemic stroke patients（P〈0.05,P〈0.01）.Conclusion Bilateral ischemic stroke on ventral median line of brain stem is a special type of vertebrobasilar infarction.Its most common cause is basilar artery perforater occlusion.Its clinical symptoms are complicated and various.The outcome is poorer in elderly ischemic stroke patients than in middle-aged and young ischemic stroke patients.
出处
《中华老年心脑血管病杂志》
CAS
2017年第9期965-970,共6页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
脑干
脑梗死
意识障碍
眼球运动障碍
四肢麻痹
磁共振成像
弥散
brain stem
brain infarction
consciousness disorders
ocular motility disorders
quadriplegia
diffusion magnetic resonance imaging
