胼胝体梗死的临床与影像学分析

Clinical and hnaging analysis of corpus callosum infarction

目的探讨胼胝体梗死患者的临床和影像学特点。方法收集符合脑梗死诊断的416例患者的临床资料，其中8例经过MRI证实为胼胝体梗死。结果胼胝体梗死占全部脑梗死患者的1．9％。7例CT扫描未显示胼胝体梗死，经非增强MRI检查显示病灶，另1例经增强M刚检查显示病灶。梗死灶可仅累及胼胝体（膝部、体部或压部），也可合并额叶、枕叶和丘脑梗死。胼胝体梗死的临床表现因具体病灶部位而异。单纯胼胝体体部梗死主要表现为对侧肢体轻瘫、共济失调和左侧肢体失用；胼胝体膝部梗死主要表现为以对侧下肢为重的瘫痪或对侧下肢轻瘫；胼胝体压部梗死可表现为肢体瘫痪和眩晕；胼胝体腔隙性梗死可无明显临床表现。合并额叶和丘脑梗死者出现精神行为症状，包括智能障碍、语言异常以及大、小便失禁。结论胼胝体梗死少见，MRI是确诊依据，临床表现缺乏特异性，与胼胝体梗死部位以及是否合并其他部位梗死有关。

Objective To investigate the clinical and imaging characteristics in patients with corpus callosum infarction. Methods The clinical data of 416 patients meeting the diagnosis of cerebral infarction were collected, in which, 8 patients were confirmed as corpus caUosum infarction by MRI. Results Corpus callosum infarction accounted for 1.9% of all patients with cerebral infarction. CT scan did not show the corpus callosum infarctions in 7 patients, The non- enhanced MRI revealed the lesions. The enhanced MRI revealed the lesion in another patient. The infarction foci were not only involved in the corpus callosum （knee, body or splenium）, but also complicated with frontal lobe, occipital lobe and thalamus infarctions. The clinical manifestations of the corpus callosum infarction were different due to the specific lesion sites. The simple infarction in the body of the corpus callosum mainly presented as contralateral paraparesis, ataxia, and left limb apraxia; the infarction in the knee of the corpus callosum mainly presented as lower limb paralysis or contralateral paraparesis; the infarction in the splenium of the corpus callosttm presented as limb paralysis and dizziness; the lacunar infarct in the corpus callosttrn had no obvious clinical manifestations. The patients who complicated with frontal lobe and thalamus infarction had behavioral and psychological symptoms, including mental retardation, language abnormalities, and incontinence. Conclusions Corpus callosum infarction is not common. MRI is the basis of diagnosis. The clinical manifestation is lack of specificity, and it is associated with the location of corpus callosum infarction and whether it complicates with the infarction on other part.