Erro M E, Gállego J, Herrera M, Bermejo B
Unidad de Ictus, Servicio de Neurología, Hospital de Navarra, Pomplona, Spain.
Eur J Neurol. 2005 Dec;12(12):984-8. doi: 10.1111/j.1468-1331.2005.01119.x.
Although there are several clinico-topographical studies of pontine infarcts, few include vascular studies. To clarify the etiopathogenic mechanisms of pontine infarcts we analyzed the vascular findings and their association with MRI lesions. The clinical features and vascular findings on transcranial Doppler (TCD) or MR angiography (MRA) of 67 patients with acute infarcts involving the pons were studied. Functional outcome was assessed by modified Rankin Scale (mRS) scores on admission and 2 months later. Two groups of isolated pontine infarcts were found on the basis of lesion location on MRI, according to the extent or not to the anterior surface of the pons: paramedian pontine infarcts (PPI, n = 36) and lacunar pontine infarcts (LPI, n = 31). Hypertension was the most common vascular risk factor and pure motor syndrome was the most frequent clinical profile in both groups. Basilar artery stenosis found on TCD or MRA was significantly more frequent amongst the PPI group (P < 0.05). On admission and 2 months later, the mRS scores of the PPI group were significantly worse (P < 0.0001) than those of the LPI group. Patients with PPI have a significantly higher frequency of basilar artery stenosis and they have a worse prognosis than patients with LPI.
虽然有多项关于脑桥梗死的临床-影像学研究，但很少有涉及血管方面的研究。为了阐明脑桥梗死的病因发病机制，我们分析了血管方面的发现及其与MRI病变的关联。对67例急性脑桥梗死患者的经颅多普勒（TCD）或磁共振血管造影（MRA）的临床特征和血管方面的发现进行了研究。根据入院时及2个月后的改良Rankin量表（mRS）评分评估功能转归。根据MRI上的病变位置，将孤立性脑桥梗死分为两组，根据是否累及脑桥前表面：脑桥旁正中梗死（PPI，n = 36）和腔隙性脑桥梗死（LPI，n = 31）。高血压是最常见的血管危险因素，两组中纯运动综合征是最常见的临床类型。TCD或MRA发现的基底动脉狭窄在PPI组中明显更常见（P < 0.05）。入院时及2个月后，PPI组的mRS评分明显比LPI组差（P < 0.0001）。PPI患者基底动脉狭窄的发生率明显更高，且其预后比LPI患者更差。
