伴有卵圆孔未闭的隐源性脑梗死的临床特点

Clinical features of cryptogenic stroke accompanied with patent foramen ovale

目的 探讨伴有卵圆孔未闭（PFO）的隐源性脑梗死的临床特点。方法 回顾性分析8例伴有PFO的隐源性脑梗死患者的临床资料。结果 8例患者年龄15~55岁,平均39.75岁,均急性起病。主要临床表现为肢体无力5例,言语障碍2例,行走不稳、双下肢无力、癫痫发作、偏身针刺觉减退各1例。超声心动图检查示患者均有PFO。头颅MRI表现为额叶、顶叶、颞叶、枕叶、岛叶皮质、脑室体旁、内囊后肢、基底节、小脑半球T1低信号,T2高信号;单侧受累4例,双侧受累4例;6例为多发病灶,2例为单一病灶;累及前循环系统4例,后循环系统1例,前后循环均累及3例。8例患者治疗后未再复发。结论 伴有PFO的隐源性脑梗死患者发病年龄相对偏小。头颅MRI多发病灶多见,可累及双侧,前后循环系统均可受累。伴有PFO的隐源性脑梗死预后较好。

Objective To investigate the clinical features of cryptogenic stroke accompanied with patent foramen ovale （PFO）. Methods The clinical data of 8 cryptogenic stroke patients accompanied with PFO were analyzed retrospectively. Results Eight patients aged 15 -55 years old, average age was 39.75 years old. They were acute onset. The clinical symptoms were limb weakness in 5 cases, speech disorder in 2 cases, walking instability, weakness of lower limbs, epilepsy, acmesthesia decrement of one side in 1 case retrospectively. Doppler echoeardiography showed PFO was in all the patients. Brain MRI showed frontal lobe, parietal lobe, temporal lobe, occipital lobe, insular cortex, periventricular body, hind limb of the internal capsule, basal ganglia, cerebellum had low T1 single, and high T2 single. Four cases were urtilateral involvement, and 4 cases were bilateral involvement; 6 eases were multiple lesions, 2 cases were single lesion ; involved in anterior circun systemlatio system was in 4 cases, involved in posterior circulation system was in 1 case, and involved in anterior and posterior circulation system was in 3 cases. All cases had no recurrence after treatment. Conclusions The onset age of cryptogenic stroke patients accompanied with PFO is relatively young. Brain MRI shows multiple lesions, it can involed in bilateral, anterior and posterior circulation system. Prognosis of cryptogenie strok accompanied with PFO is good.