颈动脉系统盗血综合征3例临床分析

目的探讨颅内盗血的临床特点、机制及检查手段。方法 3例脑梗死患者进行头颅MRI+MRA,TCD,颈部血管彩超,DSA检查比较。结果 3例患者均发现:①轻活动状态下起病;②体征,症状相对较轻,临床预后相对好;③头颅MRI分水岭区病灶多斑块,串珠样;④血管检查显示责任血管与责任病灶不一致;⑤临床治疗保证灌注压是关键。结论在脑血管狭窄中出现与病变血管不一致的临床表现,要考虑颅内盗血现象,且DSA检查是最直观可靠的手段;预后良好,但慎用扩血管药物。

Objective To investigate the clinical characteristic ,mechanisms and examine means of int- racal steal syndrome. Methods 3 cases of cerbral infarction patients who undertook head＇s Magnetic Resonance Imaging （MRI） ＋ Magnetic Resonance Angiography （MRA） , Transcranial Doppler Sonography （ TCD ） , co- lourful doppler sonography of cervical vessel and Digital Subtraction Angiography （DSA） were analyzed retro- spectively. Results The narrow of arteria carotis interna in intracal segment or outer segment led to intraeal steal syndrome. Watershed infarct in blood-supply area nearby, which was caused by the intracal steal syn- drome, was found in all the 3 cases. Conclusion Intracal steal syndrome should be considered when clinical manifestation and the part of brain＇s angiostegnosis are incompatible, and Digital Subtraction Angiography （DSA） is direct and reliable.