Kim Hyun-Ah, Lee Hyung, Sohn Sung-Il, Yi Hyon-Ah, Cho Yong-Won, Lee Seong-Ryong, Park Byung-Rim
Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea.
J Neurol Sci. 2006 Jul 15;246(1-2):103-9. doi: 10.1016/j.jns.2006.02.013. Epub 2006 Mar 29.
The aim of this study was to document the clinical presentation, vascular topographic patterns, stroke mechanism, and outcome of bilateral infarcts in the territory of the superior cerebellar artery (SCA) based on data collected from a prospective acute stroke registry.
We studied the clinical and radiological features of 11 patients with bilateral infarctions in the territory of the SCA diagnosed by brain MRI.
Bilateral SCA infarcts represented 23.4% (11/47) of all SCA territory infarction. Bilateral SCA infarcts mostly associated with brainstem (n = 5), cerebral (n = 5), or non-SCA cerebellar lesions (n = 4). The most common clinical presentation at onset was sudden fall with axial lateropulsion and dysarthria (n = 6). In five patients with a coexisting infarct(s) in the brainstem, limb weakness and/or mental change were prominent and often masked the signs of cerebellar dysfunction. Six patients showed no stenosis or occlusion in the vertebrobasilar system on brain MRA. Five had an obvious cardiac source of emboli. Eight patients showed favorable outcomes with complete recovery or minimal disability, but three patients with additional extensive brainstem infarcts died within 1 week.
Bilateral SCA territory infarcts show variable clinical, vascular topographic, and prognostic features. They usually result from cardiac emboli.
本研究旨在基于前瞻性急性卒中登记处收集的数据，记录小脑上动脉（SCA）供血区域双侧梗死的临床表现、血管地形模式、卒中机制及预后。
我们研究了11例经脑部MRI诊断为SCA供血区域双侧梗死患者的临床和影像学特征。
双侧SCA梗死占所有SCA供血区域梗死的23.4%（11/47）。双侧SCA梗死大多与脑干病变（n = 5）、大脑病变（n = 5）或非SCA小脑病变（n = 4）相关。发病时最常见的临床表现为突发跌倒伴轴向侧推和构音障碍（n = 6）。5例合并脑干梗死的患者，肢体无力和/或精神改变较为突出，常掩盖小脑功能障碍的体征。6例患者脑部MRA显示椎基底系统无狭窄或闭塞。5例有明显的心源性栓子来源。8例患者预后良好，完全恢复或仅有轻微残疾，但3例合并广泛脑干梗死的患者在1周内死亡。
双侧SCA供血区域梗死具有多样的临床、血管地形和预后特征。它们通常由心源性栓子引起。
