胸椎黄韧带骨化症(thoracic ossification of the ligamentum flavum,TOLF)是脊柱韧带异位骨化性疾病之一,可导致胸椎椎管狭窄、脊髓受压,可严重影响及危害患者运动神经功能,是胸脊髓病最常见的发病原因[1]。该病起病隐匿,多数患者在外...胸椎黄韧带骨化症(thoracic ossification of the ligamentum flavum,TOLF)是脊柱韧带异位骨化性疾病之一,可导致胸椎椎管狭窄、脊髓受压,可严重影响及危害患者运动神经功能,是胸脊髓病最常见的发病原因[1]。该病起病隐匿,多数患者在外伤诱因作用下或慢性神经损伤症状急剧加重才就诊,病情往往较重,常合并其他脊柱疾病,临床表现复杂多变,容易漏诊及误诊,手术风险及难度较大,若处理不当可能造成瘫痪。展开更多
Background and purpose: Isolated pontine strokes cause characteristic neurolog ical syndromes and have a good short-term prognosis. The aim of this study was to examine the longterm survival, cumulative recurrence rat...Background and purpose: Isolated pontine strokes cause characteristic neurolog ical syndromes and have a good short-term prognosis. The aim of this study was to examine the longterm survival, cumulative recurrence rate and clinical handic ap of patients with isolated pontine infarcts of different aetiology. Methods: O ne hundred consecutive patients with an isolated pontine infarction were identif ied by imaging studies and evaluated prospectively. After extensive study, cases were classified according to the aetiopathogenetic mechanisms: stroke due to ba silar artery branch disease (BABD), small-artery disease (SAD) and large-artery-occlusive disease (LAOD). During a mean follow-up period of 46 months, stroke presentation and initial course, early and long-term mortality, disability and recurrence were evaluated. Results: BABD was the most frequent c ause of isolated pontine ischaemia (43 %), followed by SAD (34%) and LAOD (21 %). Hypertension was the most prominent risk factor, especially among patients with SAD (94.1 %). Neurological impairment on admission was more severe in the LAOD group, followed by BABD. After 1 month patients with LAOD had the highest c umulative mortality (14.3%, p=0.026) and more severe disability (61.1%, p=0.00 1). Fiveyear mortality rate was 20.6%, 14%and 23.8%in the SAD-, BABD-and in LAOD-group respectively (p=0.776). Cumulative 5-year recurrence rate was 2.3 %for BABD, 14.3 %for LAOD, and 29.4 %for SAD (p=0.011). Conclusions: Overall long-term survival of patients with isolated pontine infarcts is good. Initial differences regarding short-term outcome in infarctions of different aetiology resolve with time. Effective secondary prevention among SAD patients may limit s troke recurrence and positively influence long-term prognosis.展开更多
文摘胸椎黄韧带骨化症(thoracic ossification of the ligamentum flavum,TOLF)是脊柱韧带异位骨化性疾病之一,可导致胸椎椎管狭窄、脊髓受压,可严重影响及危害患者运动神经功能,是胸脊髓病最常见的发病原因[1]。该病起病隐匿,多数患者在外伤诱因作用下或慢性神经损伤症状急剧加重才就诊,病情往往较重,常合并其他脊柱疾病,临床表现复杂多变,容易漏诊及误诊,手术风险及难度较大,若处理不当可能造成瘫痪。
文摘Background and purpose: Isolated pontine strokes cause characteristic neurolog ical syndromes and have a good short-term prognosis. The aim of this study was to examine the longterm survival, cumulative recurrence rate and clinical handic ap of patients with isolated pontine infarcts of different aetiology. Methods: O ne hundred consecutive patients with an isolated pontine infarction were identif ied by imaging studies and evaluated prospectively. After extensive study, cases were classified according to the aetiopathogenetic mechanisms: stroke due to ba silar artery branch disease (BABD), small-artery disease (SAD) and large-artery-occlusive disease (LAOD). During a mean follow-up period of 46 months, stroke presentation and initial course, early and long-term mortality, disability and recurrence were evaluated. Results: BABD was the most frequent c ause of isolated pontine ischaemia (43 %), followed by SAD (34%) and LAOD (21 %). Hypertension was the most prominent risk factor, especially among patients with SAD (94.1 %). Neurological impairment on admission was more severe in the LAOD group, followed by BABD. After 1 month patients with LAOD had the highest c umulative mortality (14.3%, p=0.026) and more severe disability (61.1%, p=0.00 1). Fiveyear mortality rate was 20.6%, 14%and 23.8%in the SAD-, BABD-and in LAOD-group respectively (p=0.776). Cumulative 5-year recurrence rate was 2.3 %for BABD, 14.3 %for LAOD, and 29.4 %for SAD (p=0.011). Conclusions: Overall long-term survival of patients with isolated pontine infarcts is good. Initial differences regarding short-term outcome in infarctions of different aetiology resolve with time. Effective secondary prevention among SAD patients may limit s troke recurrence and positively influence long-term prognosis.
