Lanzino G, Andreoli A, Di Pasquale G, Urbinati S, Limoni P, Serracchioli A, Lusa A, Pinelli G, Testa C, Tognetti F
First Division of Neurosurgery, Ospedale Bellaria, Bologna, Italy.
Acta Neurol Scand. 1991 Oct;84(4):321-5. doi: 10.1111/j.1600-0404.1991.tb04962.x.
Etiology and long-term prognosis were prospectively investigated in 155 consecutive patients (96 men and 59 women), aged 16 to 45 years, referred to our Neurosurgical Unit with cerebral transient ischemic attacks or infarction during the period 1978-1988. All patients underwent neurological and medical-cardiological evaluation, cerebral computerized tomography scanning, electrocardiogram, and laboratory tests. Two-dimensional echocardiography was performed in 123 cases (79%), cerebral angiography in 147 (95%). Atherosclerosis was the leading etiology occurring in 48 patients (31%). A cardioembolic disorder was considered the probable cause of ischemia in 8 cases (5.1%). Further possible etiologies were contraceptive pill assumption (5.8% of the total, but 15.3% within the female group), spontaneous arterial dissection (4.5%), migraine (4%), puerperium (2.6%), cervical trauma (2.6%), and other, more uncommon conditions. Despite extensive evaluation, the cause of cerebral ischemia remained unknown in 40% of cases. All patients received antiplatelet medication and 16 underwent surgery. The long-term outcome at a mean follow-up of 5.8 years was favorable: 91% of subjects resumed their work on a full or part-time basis.
对1978年至1988年间因脑短暂性缺血发作或梗死转诊至我们神经外科的155例连续患者（96例男性和59例女性，年龄16至45岁）的病因及长期预后进行了前瞻性研究。所有患者均接受了神经学和医学 - 心脏病学评估、脑部计算机断层扫描、心电图及实验室检查。123例（79%）患者进行了二维超声心动图检查，147例（95%）进行了脑血管造影。动脉粥样硬化是主要病因，48例患者（31%）出现该病因。8例（5.1%）患者的缺血可能由心脏栓塞性疾病引起。其他可能病因包括服用避孕药（占总数的5.8%，但在女性组中占15.3%）、自发性动脉夹层（4.5%）、偏头痛（4%）、产褥期（2.6%）、颈部创伤（2.6%）以及其他更罕见的情况。尽管进行了广泛评估，40%的病例中脑缺血病因仍不明。所有患者均接受了抗血小板药物治疗，16例接受了手术。平均随访5.8年的长期结果良好：91%的患者恢复了全职或兼职工作。
