脑桥旁正中梗死的临床与影像学特点分析

Pons near Middle of Infarction and Imaging Features

目的：本文旨在通过探讨脑桥旁正中梗死患者的临床和影像学特征，以利于临床医生的临床诊治工作。方法：回顾分析2013年9月～2014年3月通辽市医院神经内科以脑桥旁正中入院患者20例作为临床资料，分析患者的症状、体征、影像学特点及发病机制。结果：所有患者均于入院后查常规血生化并经头颅影像学确诊，其中肢体无力18例，0－5级不等，存在病灶对侧中枢性面瘫12例，言语笨拙4例，头昏患者11例，偏身麻木9例，饮水呛咳6例，构音障碍5例，面部麻木4例，单侧Babinski征阳性13例。治疗后临床治愈11例，明显进步7例，2例无明显好转怀疑与延迟就诊有关。结论：一侧脑桥旁正中梗死多位于脑桥内侧区域，主要由基底动脉深穿支动脉病变引起的；在临床中发现一侧偏瘫或偏身感觉障碍伴有头晕、构音障碍和饮水呛咳的患者均要考虑到脑桥旁正中梗死的可能，及时做MRI／MRA检查确诊。

OBJECTIVE ： To explore the clinical characteristics of pons near middle of infarction and imaging features so as to be useful for the clinical diagnosis and treatment of the disease. METHODS： Clinical data of 20 hospitalized patients with pons near the middle from September in 2013 to March in 2014 in our hospital were analysised retrospectivly. The patients＇ symptoms, signs, ima- ging characteristics and pathogenesis were analysised. RESULTS： Blood routine examination and head imaging were made. 18 cases had limb weakness, the range is 0 to 5, 12 cases existed lesions of the contralateral central facial paralysis, speech stupid 4 cases, 11 patients with dizziness, partial body numbness 9 cases, water choke to cough 6 cases, dysarthria 5 cases, facial numbness 4 cases and 13 cases unilateral positive Babinski sign. After treatment 11 cases were cured, among them 7 cases were obvious progress, and 2 cases had no obvious improvement relating to the late diagnosis. CONCLUSIONS ： The center of the side next to the pons infarction medial to the pons area is mainly caused by basal deep perforators artery lesions; It is found in the clinical that the patient with side of hemiplegia and partial body accompanied wih dizziness, dysarthria and water choking cough should be considered as pons infarction. MRI/MRA examination should be done in time.