内囊预警综合征的临床特征和预后

Clinical Features and Prognosis of Capsule Warning Syndrome

目的分析内囊预警综合征(capsular warning syndrome,CWS)的临床特点、影像学特征及治疗预后,以提高对此病的认识。方法回顾性分析战略支援部队特色医学中心神经内科2013年1月-2018年12月收住院治疗的CWS的临床资料、影像学特征及治疗预后情况。结果共12例患者,男性8例(66.67%),中位年龄为60岁。高脂血症9例(75.0%),高血压8例(66.67%),糖尿病4例(33.33%),肿瘤病史3例(25.0%)。纯运动性卒中4例(33.33%),运动伴有构音障碍者4例(33.33%),运动及感觉性障碍3例(25.00%),纯感觉障碍1例(8.33%)。影像学示豆纹动脉供血区新发脑梗死6例(50%)。所有患者给予口服双联抗血小板治疗,其中3例症状复发患者又给予静脉溶栓和静脉抗血小板治疗。3个月随访,所有患者均未再出现症状发作,10例mRS评分为0分,2例mRS评分分别为4分及3分。结论CWS主要表现为运动障碍,发作刻板,常见原因为动脉粥样硬化性。在本组病例中发现双重抗血小板治疗有效,静脉溶栓效果不肯定。

Objective To investigate the clinical and imaging features and prognosis of capsular warning syndrome(CWS).Methods The data of patients with CWS admitted in Department of Neurology of PLA Strategic Support Force Characteristic Medical Center from January 2013 to December 2018 were retrospectively analyzed.Results There were 12 patients including 8 males(66.67%),with the median age of 60 years old.There were 9(75.0%)cases with hyperlipidemia,8(66.67%)with hypertension,4(33.33%)with diabetes,3(25.0%)with tumor history.There were 4(33.33%)with a pure motor dysfunction,4(33.33%)with motor dysfunction and dysarthria,3(25.00%)with motor and sensory dysfunction,1(8.33%)with pure sensory dysfunction.6 cases(50%)had new cerebral infarction in lenticulostriate artery territory.All patients were given oral dual antiplatelet therapy,of whom 3 cases with repetitive symptoms were also given with intravenous thrombolysis and antiplatelet therapy.At the 3-month follow-up,all patients had no recurrent symptoms,10 patients had a mRS score of 0,and 2 patients had a mRS score of 4 and 3,respectively.Conclusions CWS patients mainly presented with repetitive episodes of motor dysfunction.The common cause of CWS is atherosclerosis.Dual antiplatelet therapy for CWS in our series of cases was effective,and intravenous thrombolysis was uncertain.