后循环脑梗死患者临床及影像学特征分析

Clinical features and imaging analysis of posterior circulation cerebral infarction

目的分析后循环脑梗死(posterior circulation cerebral infarction,PCCI)患者的临床表现、影像学特点、发病原因。方法选取头颅MRI提示有明确PCCI病灶的患者356例(PCCI组),回顾性分析其临床表现特点及影像学特征,另选前循环脑梗死(ACCI)患者853例(ACCI组),比较2组病因分型的差异。结果 PCCI患者临床症状中占前3位的分别为言语不清105例(29.5%),头晕/眩晕98例(27.5%)、肢体无力86例(24.2%);远段梗死是PCCI最常见的梗死部位(45.8%),累及部位最常见为丘脑20.2%;PCCI组动脉粥样硬化性血栓形成较ACCI组多见,差异有统计学意义(P<0.05)。结论 PCCI的临床表现复杂,PCCI最常见的梗死部位为远段,动脉粥样硬化血栓形成为PCCI最常见的发病原因。

Objective To analyze the clinical and imaging features, and further explore the etiology of posterior circulation cerebral infarction（PCCI）. Methods 356 patients with PCCI focus confirmed by head MRI were analyzed retrospectively with the clinical manifestations, imaging fea- tures,and compaired with the anterior circulation infarction in 853 cases（ACCI group） in etiology. Results Top three clinical signs were as follows：slurred speech in 105 cases（29.5%） ,dizziness/vertigo in 98 cases（27.5%） ,muscle strength decreased in 86 patients（24.2%） ;distal infarction is the most frequent（45.8%） in PCCI with 20.2% in the hypothalamus;AT in PCCI was more frequent than ACCI （anterior circulation cerebral infarction） （P〈0.05）. Conclusion The clinical manifestations of PCCI are complex. Classical brainstem syndrome is meaningful for the further localization confirmed by head MRI. Distal infarction is the most common location in PCCI. Atherosclerotic thrombosis is also the most common cause of PCCI nosopoiesis.