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慢性心房纤颤是脑梗塞危险因素之一。据Fra-mingham 研究报导:考虑年龄、血压、心脏病等因素在内,心房纤颤病人首次脑梗塞发生率比窦性心律者多5.6倍。缺血性卒中首次发病可无临床症状;反复发作的心源性多灶性梗塞可导致进行性的、严重的认识障碍和痴呆,而无典型卒中表现。作者对1980～1985年住院的160例房颤伴脑梗塞病人进行回顾性研究。其中63例有头颅CT 和心电图资料。63例中9例原诊断为脑梗塞而CT 证实为脑出血,故除外。有趣的是这9例中有1例系右颞顶叶出血,CT 扫描见2个无症状性梗塞灶。另54例中7例(13%)CT 证实有陈旧性无症状性脑梗塞灶。4例系重度、2例系轻度卒中,1例系痴呆。2例仅表现进行性认识障碍,CT 提示系多发性梗塞,2例均有4个无症状性梗塞灶。7例病人的梗塞灶分别位于外囊、额叶、顶叶、枕叶或小脑。病灶位于单侧或双
Chronic atrial fibrillation is one of the risk factors of cerebral infarction. According to Fra-mingham research reports: considering age, blood pressure, heart disease and other factors, the incidence of first-episode cerebral infarction in patients with atrial fibrillation 5.6 times more than sinus rhythm. The first onset of ischemic stroke can be asymptomatic; recurrent cardiogenic multifocal infarcts can lead to progressive, severe cognitive impairment and dementia without typical stroke manifestations. The authors retrospectively reviewed 160 hospitalized patients with atrial fibrillation and cerebral infarction from 1980 to 1985. 63 cases of cranial CT and ECG data. Of the 63 cases, 9 were originally diagnosed as cerebral infarction and the CT was confirmed as cerebral hemorrhage, so it was excluded. It is interesting to note that one of the nine cases had bleeding in the right temporal parietal region and two asymptomatic infarcts in the CT scan. In the other 54 cases, 7 cases (13%) had confirmed old asymptomatic cerebral infarction. 4 were severe, 2 were mild stroke, and 1 was dementia. 2 cases showed progressive cognitive impairment, CT showed multiple infarcts, 2 cases had 4 asymptomatic infarcts. Seven patients with infarction were located in the outer capsule, frontal lobe, parietal lobe, occipital lobe or cerebellum. Lesions are located on one or both sides