双侧大脑前动脉梗死区临床特点及发病机制探讨

Clinical characteristics and pathogenesis of infration in bilateral anterior cerebral artery

目的探讨双侧大脑前动脉分布区梗死的临床特点和机制。方法回顾分析3例急性双侧ACA分布区脑梗死患者的临床特点和头MRI、MRA等资料。结果 3例患者均有脑血管病危险因素,包括高血压、糖尿病、吸烟、高HCY等。临床症状包括淡漠、欣快、不同程度肢体瘫痪和尿便障碍。存在严重的动脉硬化和(或)血管变异。结论情感障碍、肢体瘫痪和尿便障碍是主要临床表现,ACA解剖变异伴ICA/ACA局部狭窄或双侧ACA和MCA严重狭窄是双侧ACA分布区梗死发病的重要因素。

Objective To investigate the clinical characteristics and possible mechanisiams of bilateral anterior cerebral artery infarction.Methods 3patients with bilateral anterior cerebral infaration were retrospectively analyzed including the data of patients ’ clinical and neuroimaging（MRI,MRA and TCD）.Results All 3patients had risk factors for cerebrovascular disease,including hypertension,diatebes melitus,cigarette and high HCY;The clinical symptoms included motor dysfunction,nonchalant / euphoria and urinary disorder;Thses patients had severe atherosclerosis and vessel heteromorphosis.Conclusion Motor dysfunction,hypobuli / indifference and urinary disorder are common symptom,and bilateral MCA / ACA atherosclerosis and anatomic variants of ACA are key factors of stroke.