内囊预警综合征18例临床分析(附高分辨核磁成像研究)

Clinical analysis of 18 cases of capsular warning syndrome(report of comprehensive high resolution magnetic resonance imaging study)

目的探讨内囊预警综合征（Capsular warning syndrome,CWS）的临床特征及高分辨核磁影像学表现。方法对2010年2月~2013年12月18例连续住院CWS患者的临床及高分辨核磁进行回顾性分析。结果18例CWS患者中,17例高血压,11例高脂血症,吸烟史7例。9例表现为纯运动症状,1例表现为纯感觉症状,6例表现为运动感觉同时受损,2例表现为构音障碍手笨拙。15例患者高分辨核磁可见大脑中动脉斑块。结论 CWS与大动脉病变有关,大脑中动脉上、后壁斑块通过堵塞穿支动脉开口诱发缺血发作,而前、下壁斑块可能通过斑块脱落诱发缺血事件。

Objective To investigate the clinical features of capsular warning syndrome（CWS） and evaluate the relationship between stenosis of middle cerebral artery and capsular warning syndrome by the high resolution magnetic resonance imaging.Methods 18 consecutive CWS patients hospitalized during period of time from February 2010 to December2013 were retrospectively analyzed.Results In these 18 patients with CWS,17 had hypertension,11 had hyperlipidemia,7 were smoker.9 cases showed pure motor symptoms,and 6 cases showed pure sensory symptoms,one case showed sensormotor symptoms and 2 cases showed clumsy hand dysarthria syndrome.High resolution MRI revealed that 15 patients had middle cerebral artery atherosclerotic plaque.Conclusions CWS was highly associated with Large atherosclerotic lesions.The superior-dorsal wall plaque that blocked the orifice of perforator arteries induced CWS,and the patch of vulnerable plaque in ventral-inferior wall probably induced artery to artery embolism.