32例基底动脉尖综合征临床分析

目的探讨基底动脉尖综合征（TOBS）的发病因素、临床特点、诊疗及预后。方法对2010年6月至2014年6月32例基底动脉尖综合征患者的临床资料进行回顾性分析。结果TOBS患者以中老年为主，发病因素与高血压、糖尿病、心脏病、高血脂、动脉粥样硬化等相关，临床特点多以眩晕或意识障碍起病，常合并有眼球活动障碍、瞳孔异常、肢体活动障碍、视觉障碍等。影像学特点为中脑、丘脑、颞叶、枕叶及小脑的多发梗死灶，其中双侧丘脑蝶形低密度影最具特征性。诊疗及预后：基底动脉尖综合征的治疗主要包括溶栓及脑血管疾病的常规综合治疗。基底动脉尖综合征的预后与责任病变部位、受累病变个数及并发症有关。结论TOBS临床特点复杂多样，头颅CT及MRI检查有助于早期诊断，早期综合治疗可改善患者预后。

Objective To study the top of the basilar syndrome （ TOBS ） etiological factor, clinical manifestation, diagnosis, treatment and prognosis. Methods The clinical data of 32 cases of our hospital from June 2010 to June 2014 were analyzed. Results Most of the cases were middle or old aged.The etiological factors were related to hypertension, diabetes, heart disease, hyperlipidemia, atherosclerosis, and so on.The clinical manifestation comprised the sudden vertigo or unconsciousness with the dismovement of the eyeballs and the abnormality of the pupils as well as the hemiplegia, vision disorder.CT or MRI shows there were more than two focus of infection in midbrain, thalamus, temporal lobe, occipital lobe and cerebellum.The most characteristic image was the butterfly low density shadow in the bilateral thalamus .The treatment of TOBS includes thrombolysis and conventional treatment. The prognosisof TOBS was connected with the location and number of affected lesions, as well as complication. Conclusion The basilar artery syndrome has all kinds of clinical manifestation.The early diagnosis depends on CT or MRI.Systemic and comprehensive treatment may improve the prognosis of patients.