基底动脉尖综合征临床及MRI特征

Clinical and MRI Analysis of Top of the Basilar Syndrome

目的探讨基底动脉尖综合征(TOBS)的临床特征与MRI特点。方法回顾性分析TOBS患者的临床资料,分析其临床症状体征、MRI及MRA表现特点、危险因素或病因及随访情况。结果 16例TOBS患者男5例,女11例,发病因素可能与高血压、高脂血症、动脉粥样硬化、糖尿病等疾病相关。临床上多以眩晕或意识障碍起病,伴眼球运动障碍、瞳孔异常、肢体活动障碍等。MRI表现均累及多个脑区的多发病灶,以中脑、小脑、丘脑、枕叶、颞叶受累最常见,MRA显示基底动脉尖部狭窄或闭塞。本组以溶栓及缺血性卒中的常规综合治疗为主,预后与病变部位、数目、大小及并发症等有关。结论 TOBS临床表现复杂多样,MRI及MRA可明确诊断。

Objective To explore the clinical and MRI features of the top of the basilar syndrome（ TOBS）. Methods The clinic data of 16 patients with TOBS（ 5 males and 11 females） were analyzed retrospectively,including symptoms and signs,MRI and MRA features,risk factors and follow- up visit. Results The pathogenesis might be related to hypertension,hyperlipidemia,atherosclerosis,diabetes,etc,starting with dizziness or consciousness disorders（ accompanied by abnormal eye movement,pupil and limb movement）. MRI showed multiple lesions occurred in several brain regions,especially in midbrain,cerebellum,thalamus,occipital lobe and temporal lobe and the basilar artery was in stenosis or occlusion.The patients were treated with conventional thrombolytic therapy and ischemic stroke. The prognosis was related to the location,numbers,sizes and complications. Conclusion The clinical features of TOBS are complex and diverse. The MRI and MRA can be used to clearly diagnose it.