孤立脑干梗死的病因和临床特点研究进展

Research progress of the cause of isolated brain stem infarction and clinical researches

脑干是维持患者生命活动和意识状态的重要中枢,脑干梗死后,若不及时就医,病死率、致残率极高。脑干梗死是脑血管疾病中最为严重的一类疾病,孤立的脑干梗死灶多由脑干供血的穿支动脉病变引起,病因可能是供血动脉粥样硬化斑块导致分支阻塞,也可能是由于穿支小动脉的玻璃样变性或纤维素样坏死引起。核磁影像技术的发展及在临床诊断中的广泛应用,提高了脑干梗死的检出率,可以显示责任病灶的位置和大小以及供血动脉情况。脑干梗死的病因不同,患者的临床影像特点、症状及预后也不同,临床工作中需要注意区分采取不同的治疗措施,以减少患者的不良预后。本文从孤立的脑干梗死患者的病因、发病机制、临床特点及预后等方面做一综述。

Brain stem is an important center to maintain the life activities and consciousness status of patients.After brain stem infarction,without visiting a doctor in time,the mortality and disability rate are quite high.Brainstem infarction is one of the most serious cerebrovascular diseases.Isolated brainstem infarcts are mostly caused by the lesions of perforating arteries supplying blood to the brainstem.The etiology may be branch obstruction caused by blood supply atherosclerotic plaque,or vitreous degeneration or fibronectin like necrosis of perforating arterioles.The development of magnetic resonance imaging technology and its wide application in clinical diagnosis have improved the detection rate of brainstem infarction,which can show the location and size of responsible lesions and the situation of blood supply arteries.The etiology of brainstem infarction is different,and the clinical imaging characteristics,symptoms and prognosis of patients are also different.In clinical work,it is necessary to pay much attention to distinguishing and taking different treatment measures to reduce the adverse prognosis of patients.This article reviews the etiology,pathogenesis,clinical characteristics and prognosis of isolated brainstem infarction.