脑干梗死临床特点分析

Clinical Analysis of Patients with Brainstern Infarction

目的 探讨脑干梗死的临床和影像学特点.方法 回顾性分析62例脑干梗死患者的临床表现和影像学资料.结果 62例患者平均年龄71.7±23.23岁;危险因素有高血压56例（90.32%）,糖尿病40例（64.52%）,冠心病40例（64.52%）;常见症状为眩晕36例（58.06%）、肢体无力32例（51.61%）、肢体麻木30例（48.39%）;头MRI检查发病部位依次为桥脑38例（61.29%）,延髓16例（25.81%）,中脑8例（12.9%）.梗死灶直径〈0.5cm 36例（58.06%）,0.5～1.0cm 16例（25.81%）,〉1.0cm 10例（16.13%）.结论 脑干梗死常见于有脑血管病危险因素的老年人,常见临床症状是眩晕、肢体无力,常见发病部位是桥脑,但部分病人症状不典型,临床表现多样,严重时死亡,轻症病人可以无神经定位体征,部分病人临床表现酷似大脑半球病变,容易混淆.

Objective To investigate the clinical feature and image manifestation of brainstern infarction. Methods The clinical feature and image manifestation of 62 patients with brainstern infarction were analyzed retrospectively.Retults Most patients are old,the average age was 71.7± 23.23.Risk factors for stroke included hypertension（90.32%）,diabetes mellitus（64.52%）,coronary heart disease（64.52%）.The common symptom of brainstern infarction in turn is vertigo（58.06%）,limb paralysis（51.61%）,and limb anaesthesia（48.39%）.MRI pathological changes location by turns pontine,medulla oblongata, midbrain.The diameter of pathological changes 〈 0.5cm（58.06%）,0.5- 1.0cm（25.81%）, 〉 1,0cm（16.13%）.Conclusion The old patients with history of hypertension,diabetes mellitus and coronary heart disease have more possibility suffering from brainstern infarction.The common symptom of brainstern infarction is vertigo and limb paralysis.Predilection site is pontine,someone had variety of clinical feature,serious cases died,mild cases may have no location objective sign. The appearance of some patients seemed mimic cerebral hemisphere infarction,we should pay more attention to it.