21例椎基底动脉闭塞的临床和病理所见

Clinical and pathological observations on vertebro-basilar arterial occlusion (a report of 21 cases).

21例椎基底动脉闭塞发病高峰期临床表现为:(1)昏迷或闭锁综合征。(2)四肢瘫。(3)中枢性高热。(4)呼吸衰竭。(5)去脑强直发作。血管闭塞的原因;血栓形成15例,脑动脉粥样硬化3例,脑栓塞3例。梗塞灶主要波及桥脑、中脑及小脑,少数可波及枕、颞叶、丘脑或延髓。早期脑CT扫描假阴性率较高,脑干诱发电位有助于早期定位诊断。

21 cases of vertebro-basilar arterial occ-lusion were investigated. Their clinicalfeatures on acute stage are coma or lo-cked-in syndrome, central fever, quadrip-legia, respiratory failure and decerebraterigidity. The causes of artery occlusionwere studied. 15 cases are identified asatherothrombus, 3 cerebral atherosclero-sis, 3 cerebral embolish. Infarctions of-ten extend to pons, midbrain and cereb-ellum, occasionally extend occipita1, te-mporal lobes, thalamus or medullas.Fause negative rates of eraly CT scann-ing are very high. Brain stem evokedpotential can contribute to early diagn-osis.