Department of Rehabilitation Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan.
Neurol Sci. 2012 Aug;33(4):759-64. doi: 10.1007/s10072-011-0812-0. Epub 2011 Oct 7.
We examined the clinical features of patients with pontine infarction in the acute stage and the factors affecting functional prognosis and outcome. Lesions, neurological manifestations at initial physical status examinations, cognitive function, swallowing function and outcome [activities of daily living (ADL), status of nutritional intake at discharge and destination after discharge] were evaluated in 68 patients (47 males and 21 females) who had pontine lesions with acute phase cerebral infarction. The mean length of stay was 24.4 days. The symptoms (number of patients) observed included paralysis (50), dysarthria (47), ataxia (18), diplopia (11), dysphagia (49) and poor cognitive performance (37). The types of lesions (number of patients) included lacunar infarcts in the ventral pontine area (15), lacunar infarcts in the dorsal pontine area (13) and large lacunar infarcts (LLIs) (41). After hospital discharge, 23 patients were discharged home, 44 were transferred to another hospital and 1 died. Twenty-three patients were on a regular diet, 22 were receiving a dysphagia diet and 22 were on enteral feeding at discharge. Patients with LLIs more frequently had poor cognitive performance, paralysis, dysphagia at discharge and a tendency for a longer length of stay compared with patients who had lacunar infarct. Most patients who returned home were those who were younger in age, had fewer neurological symptoms, had better cognitive function and ADL performance, and could ingest food. In an acute hospital, age, neurological symptoms, ADL, cognitive function, and dysphagia were considered important factors for determining the outcome in patients with pontine infarction.
我们研究了急性期脑桥梗死患者的临床特征以及影响其功能预后和结局的因素。对 68 例急性脑桥梗死伴桥脑病变的患者进行病变部位、发病初期神经体征、认知功能、吞咽功能以及结局（日常生活活动能力，出院时的营养摄入状况和出院去向）评估。患者平均住院日为 24.4 天。观察到的症状（患者例数）包括瘫痪（50 例）、构音障碍（47 例）、共济失调（18 例）、复视（11 例）、吞咽困难（49 例）和认知功能不良（37 例）。病变类型（患者例数）包括脑桥腹侧腔隙性梗死（15 例）、脑桥背侧腔隙性梗死（13 例）和大腔隙性梗死（41 例）。出院后，23 例患者出院回家，44 例患者转至其他医院，1 例患者死亡。23 例患者可正常进食，22 例患者给予吞咽困难饮食，22 例患者给予肠内营养。与腔隙性梗死患者相比，LLI 患者出院时认知功能不良、瘫痪、吞咽困难以及住院时间延长的可能性更高。大多数能够出院回家的患者年龄较小，神经症状较少，认知功能和日常生活活动能力较好，能够进食。在急性医院中，年龄、神经症状、日常生活活动能力、认知功能和吞咽困难被认为是影响脑桥梗死患者结局的重要因素。
