内囊警示综合征11例临床分析

Clinical analysis of 11 patients with capsular warning syndrome

目的 探讨内囊警示综合征（capsular warning syndrome,CWS）的临床特征和影像学表现.方法 对2008年11月至2009年12月11例连续住院CWS患者的临床和影像学资料进行回顾性分析.结果 11例CWS患者中,5例患者表现为单纯运动症状,4例患者表现为单纯感觉症状,2例患者表现为运动和感觉同时受累症状.10例患者接受了头颅及颈部磁共振血管造影检查,结果未发现有明显的大动脉狭窄.11例CWS患者中最后有7例发展为脑卒中,所有脑卒中病灶都位于内囊.所有的CWS患者都有脑卒中的危险因素 其中,6例是吸烟者,7例有高血压病史,5例有高血脂,1例有糖尿病史,1例既往有脑卒中病史.所有患者随访（10.2±3.4）个月后的修正Rankin评分为0.73±1.20.结论 CWS与大动脉狭窄无明显关联,而可能是一种脑的深部小动脉疾病.

Objective To evaluate the relationship between stenosis of intra- or extra-cranial cerebral large artery and capsular warning syndrome（CWS）. Methods Eleven consecutive CWS patients hospitalized during period of time from November 2008 to December 2009 were retrospectively analyzed.Result In these 11 patients with CWS, 5 patients had motor symptoms only, 4 patients had pure sensory symptoms, and 2 patients had sensorimotor symptoms. Ten patients underwent cervical contrast-enhanced MRA and intracranial MRA examination. The results showed no sign of arterial stenosis. Seven CWS patients eventually had strokes, 1 progressed to stroke despite receiving the therapy of antiplatelet and anticoagulation. All stroke lesions were located in the capsula interna. All the CWS patients had vascular risks： 7 were smoker, 8 had hypertension, 1 had diabetes mellitus, and 5 had hyperlipidemia. One patient had a history of previous stroke no patient had a history of ischemic heart disease or atrial fibrillation. At follow-up（10. 2 ±3.4）mouths, the average modified Rankin scale score for all patients was 0. 73 ± 1.20.Conclusion CWS was not associated with stenosis of the intra and extra-cranial large cerebral arteries.CWS may be associated with small-vessel single-penetrator disease.