基底动脉尖综合征临床与影像学分析

A ANALYSIS OF CLINIC AND IMAGE ABOUT TOP OF THE BASILAR SYNDROME

目的：分析ＴＯＢ综合征临床及影像学表现，以加强对该病的认识及早期诊断。方法：回顾性分析１０例临床及影像学资料，并进行对比研究。结果：意识障碍、瞳孔及眼球运动异常、偏盲或皮层盲、偏侧或四肢无力为该综合征最常见的临床特征。结合影像学检查显示：丘脑梗塞最常见（９／１０），其次为中脑或桥脑（８／１０），并可同时伴有枕叶及小脑半球梗塞。头颅ＣＴ最具特征性改变为双侧丘脑蝶形低密度，伴有中脑或桥脑上部中央及旁中央区低密度（ＭＲＩ像上为Ｔ１低信号，Ｔ２高信号改变）。ＭＲＩ对该病的诊断较ＣＴ敏感。结论：ＴＯＢ综合征同时具有幕上及幕下多处梗塞，预后较差。临床拟诊病人早期行ＭＲＩ检查更能提高诊断率。

Objective: To analyze the clinical and image findings of TOB syndrome, for strengthening recognition and early diagnosis Methods: Retrospectively 10 cases TOB syndrome, comparing with clinical, head CT and MRI data Results: Demonstrated unconsciousness, pupillo-oculomotor abnormality, hemianopsia or asimultagnosia, hemiparesis or bilateral paresis were the most frequent characteristics of this syndrome The thalamic infarctions were the most frequent (9/10), midbrain or pons infarctions secondary (8/10), may be associated with occipital lobe and cerebellar infarctions Bilateral thalamus batterfly hypodensity following by midbrain or pons centerparamedian area hypodensity were the CT-scaning characterizations (MRI was a low signal on T1W image and a high signal on T2W image) MRI was supperior to CT in detecting these lesions Conclusion: TOB syndrome covered the supra and infra-tentorial multiple infarctions had worse prognosis As early as possible clinical suspected cases are performed MRI for early diagnosis and treatment