肢体抖动型短暂性脑缺血发作的临床和血管相关检查分析及长期随访

Analysis of clinical characters,cerebral artery examinations and follow-up in patients with limb-shaking transient ischemic attack

目的分析肢体抖动型短暂性脑缺血发作（1imb—shaking transient ischemic attack，LS—TIA）的临床及血管病变特点。方法采用回顾性分析方法，收集我院2011年1月～2013年10月间以发作性肢体抖动为临床表现的TIA患者，收集患者的临床资料及治疗方案，记录临床和影像学随访结果，记录随访期间有无脑血管事件发生。结果共收集肢体抖动型TIA患者5例，均存在抖动肢体对侧的颅内外大动脉重度狭窄或闭塞，除1例烟雾病患者，其余4例均接受抗血小板、强化他汀治疗，其中2例接受颈内动脉支架植入术治疗。发病后6个月复查头部MRI均未见新发梗死灶，临床随访6—33个月，均无脑血管事件发生。结论单侧肢体抖动是TIA的一种发作形式，多存在对侧的颅内外大动脉重度狭窄或闭塞，血管重建治疗及规范的药物治疗对减少脑血管事件可能均有效。

Objective To investigate the clinical characters and cerebral artery examinations in patients with limbshaking transient ischemic attack （LS-TIA）. Method A retrospective analysis was selected. Patients with LS-TIA who came to our hospital between January 2011 to October 2013 were collected. The clinical data were recorded. The following- up results of clinic and imaging were collected. During the follow-up time, all the cerehrovascular events were recorded. Result Five patients were collected. All of them had unilateral limbs shaking and severe artery stenosis or occlusion in the contralateral side. Except one Moyamoya disease case,the remaining four cases received secondary prevention including anti-platelet and statin therapy etc. Two of the four cases underwent carotid artery stenting. At the 6th month following-up, brain MRI showed that none of the patients had new infarction lesions. During the whole follow-up time （6 - 33 months） , none of the patients had cerebrovascular event. Conclusion Unilateral limb shaking is a form of TIA. Severe stenosis or occlusion are often presented in the contralateral intracranial or extracranial large artery. Revascularization and standard drug therapy might be valid in reducing cerebrovascular events.