Fisher C M
Neurology Service, Massachusetts General Hospital, Boston 02114.
Arch Neurol. 1988 Dec;45(12):1301-3. doi: 10.1001/archneur.1988.00520360019004.
In thrombosis of the basilar artery, not infrequently a hemiparesis is present at an early stage, when brain-stem signs may be absent or few, slight or equivocal. It is natural to suspect that such a hemiparesis signifies localization in a cerebral hemisphere, but unexpectedly in a few hours bilateral hemiplegia appears associated with coma or a locked-in syndrome, indicating basilar artery occlusion. I would term this disarming hemiparesis the "herald hemiparesis" of basilar artery occlusion. If the true nature of the condition is recognized early, the use of heparin and other measures may forestall disaster.
在基底动脉血栓形成时，早期常出现偏瘫，而此时脑干体征可能缺如、轻微或不明确。自然而然会怀疑这种偏瘫意味着病变定位于大脑半球，但出乎意料的是，数小时内会出现双侧偏瘫，并伴有昏迷或闭锁综合征，提示基底动脉闭塞。我将这种具有迷惑性的偏瘫称为基底动脉闭塞的“先兆偏瘫”。如果能早期识别病情的真实性质，使用肝素及其他措施或许可避免灾难的发生。
