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目的:探讨脑分水岭梗塞(CWI)的病因、类型及临床特点。方法:分析60例经头颅MRI证实的幕上CWI患者的临床及影像学资料。结果:CWI的病因为体循环低血压、脑的大动脉狭窄或闭塞、心脏疾患、血流变学异常等。皮层前型21例(35%),在大脑前动脉与大脑中动脉皮层支的边缘带,呈楔形,临床表现为偏瘫、偏身感觉障碍、经皮层运动性失语等;皮层后型24例(40%),在大脑中动脉与大脑后动脉皮层支边缘带,表现为视野缺损、经皮层感觉性失语、皮层型感觉障碍、轻瘫等;皮层下型15例(25%),在大脑中动脉皮层支与深穿支边缘带,表现为偏瘫、偏身感觉障碍,优势半球病变可有言语障碍等。结论:CWI的主要病因为体循环低血压、颈动脉狭窄或闭塞及心脏疾患,多数预后良好。
Objective: To explore the etiology, types and clinical features of brain watershed infarction (CWI). Methods: Clinical and imaging data of 60 patients with supratentorial CWI confirmed by cranial MRI were analyzed. Results: The causes of CWI were systemic hypotension, stenosis or occlusion of aortic stenosis, heart disease, abnormal blood rheology and so on. Cortical anterior type in 21 cases (35%), in the anterior cerebral artery and middle cerebral artery cortex marginal zone, was wedge-shaped, clinical manifestations of hemiplegia, partial sensory dysfunction, corticodynia, etc .; cortical posterior 24 cases ( 40%), in the middle cerebral artery and posterior cerebral artery cortex marginal zone, manifested as visual field defects, percutaneous sensory aphasia, cortical sensory disturbance, paresis; subcortical type in 15 cases (25%), in the brain Artery cortical branch and deep percussion branch edge band, manifested as hemiplegia, partial sensory dysfunction, predominant hemisphere lesions may have speech disorders. Conclusion: The main causes of CWI are systemic hypotension, carotid artery stenosis or occlusion and heart disease, most of the prognosis is good.