Kim J S
Department of Neurology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
Stroke. 1992 Jul;23(7):983-7. doi: 10.1161/01.str.23.7.983.
Although pure sensory stroke is a relatively common lacunar syndrome, the responsible lesions are often unidentified because of their small size. I reported 21 cases of pure sensory stroke in which the lesions could be identified by head computed tomography and/or magnetic resonance imaging and correlated the clinical findings with the radiological lesions.
Eleven patients had thalamic strokes. Lacunes confined to the posterolateral part of the thalamus were found in nine cases, and hemorrhages of relatively large size were found in two. Five patients showed a loss of all sensory modalities, but six with very small lacunes showed minor or restricted sensory changes. Seven patients with lacunes or hemorrhages in the lenticulocapsular region or corona radiata showed abnormalities of spinothalamic tract sensation. Two patients with a small lacune and a hemorrhage in the pontine tegmentum showed a selective sensory deficit of the medial lemniscal type. One patient with a small cortical infarct showed a cortical sensory loss that was preceded by cortical sensory transient ischemic attacks.
Pure sensory stroke can occur with lesions in various areas of the somatosensory system. Hemisensory deficits of all modalities usually are associated with a relatively large lacune or hemorrhage in the lateral thalamus, whereas tract-specific or restricted sensory changes suggest very small strokes in the sensory pathway from the pons to the parietal cortex.
尽管纯感觉性卒中是一种相对常见的腔隙综合征，但由于病灶较小，其责任病灶常常难以确定。我报告了21例纯感觉性卒中病例，这些病例中的病灶可通过头部计算机断层扫描和/或磁共振成像得以识别，并将临床发现与放射学病灶进行了关联。
11例患者发生丘脑卒中。9例发现腔隙局限于丘脑后外侧部分，2例发现相对较大的出血。5例患者所有感觉模式均丧失，但6例腔隙非常小的患者表现为轻微或局限性感觉改变。7例在豆状核囊区或放射冠有腔隙或出血的患者表现为脊髓丘脑束感觉异常。2例脑桥被盖部有小腔隙和出血的患者表现为内侧丘系型选择性感觉障碍。1例有小皮质梗死的患者表现为皮质感觉丧失，之前有皮质感觉短暂性脑缺血发作。
纯感觉性卒中可由躯体感觉系统不同区域的病灶引起。所有感觉模式的半身感觉缺失通常与外侧丘脑相对较大的腔隙或出血有关，而特定传导束或局限性感觉改变提示从脑桥到顶叶皮质的感觉通路中有非常小的卒中。
