Lee M S, Choi I S, Chung T S
Yonsei Med J. 1989;30(2):151-7. doi: 10.3349/ymj.1989.30.2.151.
The six patients included in this study had painful dysesthesia, resulting from vascular lesions in or near the thalamus, confirmed by computerized tomography(CT) brain scan. Using hexamethyl propyleneamine oxime(HM-PAO) single photon emission computed tomography(SPECT) brain scanning, regional cerebral perfusion(rCP) was demonstrated. In contrast to three patients with lesions near the thalamus who showed symmetrical cortical radioactivity, the other three patients with thalamic lesions revealed decreased rCP in the ipsilateral cerebral cortex on HM-PAO brain SPECT. We thought that the loss of afferent activating stimuli from the thalamus led to decreased cortical neuronal activity and the following hypoperfusion. In patients with thalamic syndrome resulting from thalamic lesions, the role of the remote effect of the thalamic damage and consequent cortical deregulation in the development of thalamic pain and/or neuropsychological symptoms cannot be excluded completely.
本研究纳入的6例患者存在疼痛性感觉异常，由丘脑内或其附近的血管病变所致，经脑部计算机断层扫描（CT）证实。使用六甲基丙烯胺肟（HM-PAO）单光子发射计算机断层扫描（SPECT）脑部扫描，显示了局部脑灌注（rCP）情况。与3例丘脑附近有病变且表现为对称性皮质放射性的患者不同，另外3例丘脑病变患者在HM-PAO脑SPECT上显示同侧大脑皮质rCP降低。我们认为，来自丘脑的传入激活刺激丧失导致皮质神经元活动减少及随后的灌注不足。在由丘脑病变引起的丘脑综合征患者中，丘脑损伤的远隔效应以及随之而来的皮质调节紊乱在丘脑痛和/或神经心理症状发生过程中的作用不能被完全排除。
