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为了评价后循环急性梗死的临床、影像学和预后特征,作者对过去3.5年内住入初级监护中心和洛桑卒中登记处登记的后循环急性多发性梗死病人进行了前瞻性研究。病人发生卒中后13d内(大多在1周内)经MRI(T_1、T_2、质子加权影像及钆增强影像)证实梗死灶,以三维磁共振血管造影(MRA)研究椎基底动脉系统,包括基底动脉、双侧颅内椎动脉、近段小脑动脉和大脑后动脉。并结合文献分析造成梗死的潜在病因。 结果 236例椎基底动脉缺血性卒中病人中27例(11％)为后循环急性多发性梗死,男18例,女9例,年龄32岁～87岁。9例有缺血性心脏病史,1例有非瓣膜性房颤,11例有高血压,6例有多种危险因素,6例未发现危险因素。在后循环急性多发性梗死前,3例曾发生后循环TIA。这些病人有梗死灶2个～7个(平均3.6)。25例小脑梗死中20例、17例脑干梗死中4例
In order to evaluate the clinical, radiological and prognostic features of acute posterior circulation infarction, the prospective study of patients with posterior circulation acute multiple infarction admitted to primary care centers and the Rochester Stroke Registry in the past 3.5 years was conducted. Infarcted lesions were confirmed by MRI (T_1, T_2, proton-weighted images, and gadolinium-enhanced images) within 13 days after the onset of stroke (mostly within 1 week), vertebrobasilar systems including three basilar magnetic resonance angiography (MRA) , Bilateral intracranial vertebral artery, proximal cerebellar artery and posterior cerebral artery. Combined with literature analysis of the potential causes of infarction. Results Of the 236 patients with vertebrobasilar ischemic stroke, 27 (11%) had acute posterior circulation infarction. There were 18 males and 9 females, ranging in age from 32 to 87 years. Nine patients had a history of ischemic heart disease, one had nonvalvular atrial fibrillation, 11 had hypertension, 6 had multiple risk factors, and 6 had no risk factors. Three patients had posterior circulation TIA before the posterior circulation acute multiple infarct. These patients have 2 to 7 infarcts (average 3.6). 25 cases of cerebellar infarction in 20 cases, 17 cases of brainstem infarction in 4 cases