CAJ | 학술논문

目的探讨腔隙性脑梗死患者的临床表现、影像学资料及DSA特点.方法南方医科大学珠江医院神经内科自2002年5月至2008年4月共收治经头颅CT或MR证实并行DSA检查、初次出现临床症状的腔隙性脑梗死患者133例,回顾性分析患者的临床表现、影像学资料及DSA特点.结果 133例患者中临床表现为纯运动性卒中42例(31.6%),感觉运动性卒中36例(27.1%);CT/MR检查共发现梗死灶283个,梗死灶位于内囊78个(27.6%),放射冠+半卵圆中心121个(91.0%);DSA结果显示颅内大血管病变44例(101处),其中大血管狭窄38例(95处,其中责任血管34处,非责任血管61处),烟雾病6例,单发颅内动脉动脉瘤1例.DSA阳性患者中以纯运动性卒中(21例)和感觉运动性卒中(10例)居多,梗死部位以内囊(23个)和放射冠+半卵圆中心(31个)居多,44例患者存在至少1个脑血管病高危因素.结论腔隙性脑梗死的病因多样,部分患者易出现颅内大血管狭窄,以纯运动性卒中和感觉运动性卒中最多,基底节和放射冠梗死灶为主,多存在脑血管病高危因素.
목적 탐토강극성뇌경사환자적림상표현、영상학자료급DSA특점.방법 남방의과대학주강의원신경내과자2002년5월지2008년4월공수치경두로CT혹MR증실병행DSA검사、초차출현림상증상적강극성뇌경사환자133례,회고성분석환자적림상표현、영상학자료급DSA특점.결과 133례환자중림상표현위순운동성졸중42례(31.6%),감각운동성졸중36례(27.1%);CT/MR검사공발현경사조283개,경사조위우내낭78개(27.6%),방사관+반란원중심121개(91.0%);DSA결과현시로내대혈관병변44례(101처),기중대혈관협착38례(95처,기중책임혈관34처,비책임혈관61처),연무병6례,단발로내동맥동맥류1례.DSA양성환자중이순운동성졸중(21례)화감각운동성졸중(10례)거다,경사부위이내낭(23개)화방사관+반란원중심(31개)거다,44례환자존재지소1개뇌혈관병고위인소.결론 강극성뇌경사적병인다양,부분환자역출현로내대혈관협착,이순운동성졸중화감각운동성졸중최다,기저절화방사관경사조위주,다존재뇌혈관병고위인소.
Objective To discuss the clinical manifestations, imaging data and DSA findings of lacunar infarction (LI). Methods One hundred and thirty-three patients, admitted to our hospital from May 2002 to April 2008, were chosen in our study; these patients with first onset as LI were confirmed by Head CT or MR; the clinical manifestations and imaging data were retrospectively analyzed; DSA was also performed on these patients and DSA findings were concluded. Results One hundred and thirty-three patients were clinically manifested as pure motor hemiplegia (PMH, n=42, 31.6%) and sensorimotor stroke (SMS, n=36, 27.1%). Two hundred and eighty-three lesions were noted by CT/MR examinations, including 78 locating at the endocyst (27.6%) and 121 locating at the corona radiate+greater oval center (91.0%). Forty-four patients were noted as having 101 intracranial vessel lesions by DSA, including 38 patients with angiostenosis, 6 with Moyamoya and 1 with single intracranial aneurysm; of the patients with angiostenosis, 95 lesions (34 in the offending vessels and 61 in other vessels) were found. Among the DSA (+) patients, PMH (n=21) and SMS (n=10) were mainly noted with their lesions locating at the endocyst (n=23) and the corona radiate+greater oval center (n=31); At least 1 high-risk factor such as hypertension, diabete, hyperlipemia, coronary heart disease and arial fibrillation was found in 44 patients. Conclusion The pathogeneses of LI are various. Main artery infarction may co-exist in some cases. PMH and SMS are common with their lesions frequently locating at basal ganglia area and corona radiate of the cerebral hemisphere. High risk factor exists in most patients with cerebrovascular diseases.