Intensive Care Unit, Special Hospital for Cerebrovascular Disease 'Sveti Sava', Belgrade, Serbia.
Eur Neurol. 2013;69(4):207-12. doi: 10.1159/000345272. Epub 2013 Jan 10.
Locked-in syndrome (LIS) is a condition characterized by quadriplegia and anarthria. The most common cause is a ventral pontine lesion due to atherosclerotic basilar artery disease.
Cases with LIS were prospectively identified among the patients with acute ischemic stroke over 3 years, between 2009 and 2011. Clinical characteristics, topographic localization of lesions, and outcome were determined during the first 6 months from onset of LIS.
Our case series consists of 20 patients (mean age 62 ± 10 years; range 46-82). Initially 16 patients had a reduced level of consciousness (mean 3 days; range 1-15). Respiratory disturbance, mainly as impairment of the breathing pattern, was noted in all cases. Five patients died within the first 10 days due to stroke progression or cardiac arrest. In the remaining cases the most frequent causes of death were pulmonary infections and sepsis. Overall mortality in the acute phase of LIS is 75%, and the median survival time is 42 days. There was a statistically significant association between the more extensive parenchymal brain stem lesions and observed mortality.
Ischemic LIS is commonly caused by an acute complete occlusion of the basilar artery due to atherosclerotic lesions in intracranial vertebrobasilar vessels. Mortality remains high in the acute phase of the disease.
闭锁综合征（LIS）是一种以四肢瘫痪和无言语为特征的病症。最常见的原因是由于动脉粥样硬化基底动脉疾病导致的腹侧脑桥损伤。
在 2009 年至 2011 年期间，我们对 3 年以上的急性缺血性中风患者进行前瞻性研究，以确定 LIS 患者。在 LIS 发病后的前 6 个月内，确定了临床特征、病变的局灶性定位和结局。
我们的病例系列包括 20 名患者（平均年龄 62 ± 10 岁；范围 46-82）。最初有 16 名患者意识水平降低（平均 3 天；范围 1-15）。所有患者均存在呼吸障碍，主要表现为呼吸模式受损。由于中风进展或心脏骤停，有 5 名患者在最初 10 天内死亡。在其余病例中，死亡的最常见原因是肺部感染和败血症。LIS 急性阶段的总体死亡率为 75%，中位存活时间为 42 天。脑实质脑干病变越广泛，死亡率越高。
缺血性 LIS 通常是由于颅内椎基底动脉粥样硬化病变导致基底动脉急性完全闭塞引起的。疾病的急性阶段死亡率仍然很高。
