成人烟雾病的临床表现和影像学特点

Clinical Feature and Imaging Characteristics of Moyamoya Disease in Adults

目的:分析成人烟雾病的临床表现和影像学特点。方法:对36例确诊的成人烟雾病患者的临床和影像学资料进行回顾性分析。结果:本组缺血性卒中占27.8%,临床表现以偏瘫、肢体麻木、失语常见;出血性卒中占72.2%,临床表现以头痛、意识障碍、偏瘫常见。所有患者均有颈内动脉或其分支狭窄或闭塞和烟雾血管形成。结论:成人烟雾病临床表现多样,但以出血最常见。临床上遇到无卒中危险因素的患者出现脑室或脑室周围出血、脑叶出血;出现脑梗死的患者均不存在脑卒中危险因素;脑叶梗死患者发作具有反复性,其会突发短暂性脑缺血发作(TIA)或脑梗死;两侧交替的TIA或脑梗死;颅脑CT或MRI显示多发性脑梗死或出血、出血并梗死者应高度警惕烟雾病的可能。

Objective： To analyze the clinical feature and imaging features in adult moyamoya patients.Method： Clinical and imaging data of 36 adult patients with moyamoya confirmed were analyzed respectively.Result： Ischemic stroke of the 36 patients accounted for 27.8%, with hemiplegia, numbness of limb and aphasia being commonly seen; Hemorrhagic stroke accounted for 72.2%, common manifestations included headache, disturbance and hemiplegia.Stenosis or occlusion of the internal carotid artery or its branches and moyamoya vessels were found in all the patients Conclusion： The manifestations of adult moyamoya patients are diverse, in which hemorrhagic stroke is the most commonly seen.The possibility of moyamoya disease should be on high alert when the following conditions are met： around ventricle or ventricle hemorrhage, brain hemorrhage; cerebral infarction, especially in lobe of brain, occurred in patients with no risk factors of the disease; those with repeated TIA or cerebral infarction; alternating TIA or cerebral infarction of two sides; muhiple cerebral infarction or hemorrhage, hemorrhage accompanied by infarction revealed on CT or MRI.