脑内囊后肢梗死30例患者临床表现与头颅MRI关系

摘要

目的 探讨脑内囊后肢梗死临床表现与头颅磁共振(MRI)关系.方法 分析2011年1月至2017年1月,入住本院30例内囊后肢梗死患者的临床表现和影像学资料.结果 数次短暂性脑缺血发作(TIA)后梗死4例,好转4例;症状在数日内渐加重13例;发病在24h内达高峰9例.MRI弥散加权成像,均在脑内囊后肢可见高信号,其中18例在病灶侧脑侧脑室体后部旁,同脑内囊后肢相隔0.7cm之内可见另一病灶.头颅磁共振血管照影(MRA)提示脑后循环血管狭窄17例;不伴血管狭窄基底动脉开窗畸形2例;基底动脉延长扩张症3例;病灶同侧大脑中动脉狭窄2例;病灶同侧颈内动脉狭窄1例;前后循环未见狭窄5例.结论 椎-基底动脉病变或变异同脑内囊后肢梗死有明显相关性.%Objective To explore the relationship among clinical manifestation of internal capsule posterior limb infarction and cerebral magnetic resonance imaging( MRI). Method We studied 30 cases of internal capsule posterior limb infarction hospitalized between January 2011 and January 2017. Their clinical information and results of cranial MRI and magnetic resonance angiography(MRA) were collected. Results 5 cases progressed to stroke after TIA, and 4 cases improved after transient ischemic attack (TIA); 12 cases aggravated in several days;9 cases reached its peak in 24 hours. Cranial MRI showed DWI hyperintensity in internal capsule posterior limb in all the patients. 18 cases had another lesion in lateral side of the ipsilateral ventricle, 0.7cm apart from the internal capsule posterior limb. Cranial MRA showed 17 cases showed had poor blood supply in the vertebrobasilar artery system; 2 cases had fenestration; 3 cases had basilar artery dolichoectasia; 2 case had ipsilateral MCA stenosis of the lesion; 1 case had ipsilateral ICA stenosis of the lesion; 5 cases had no stenosis. Conclusion Vertebrobasilar artery stenosis or variation are associated with internal capsule posterior limb infarction.