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以感觉减退为首发症状的急性缺血性脑卒中患者的临床特征

Clinical Features of Acute Ischemic Stroke Patients with Hypoesthesia as an Initial Symptom.

作者信息

Akimoto Takayoshi, Ogawa Katsuhiko, Hara Makoto, Ninomiya Satoko, Ishihara Masaki, Morita Akihiko, Kamei Satoshi, Nakajima Hideto

机构信息

Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan.

出版信息

Neurol Int. 2023 Mar 15;15(1):508-517. doi: 10.3390/neurolint15010030.

Abstract

This study aimed to evaluate the clinical characteristics of acute ischemic stroke (AIS) patients who experienced hypoesthesia as the initial symptom. We retrospectively analyzed the medical records of 176 hospitalized AIS patients who met our inclusion and exclusion criteria and evaluated their clinical features and MRI findings. Among this cohort, 20 (11%) patients presented with hypoesthesia as the initial symptom. MRI scans of these 20 patients identified lesions in the thalamus or pontine tegmentum in 14 and brain lesions at other sites in 6. The 20 hypoesthesia patients had higher systolic ( = 0.031) and diastolic blood pressure ( = 0.037) on admission, and a higher rate of small-vessel occlusion ( < 0.001) than patients without hypoesthesia. The patients with hypoesthesia had a significantly shorter average hospital stay ( = 0.007) but did not differ significantly from those without hypoesthesia in National Institutes of Health Stroke Scale scores on admission ( = 0.182) or the modified Rankin Scale scores for neurologic disability on discharge ( = 0.319). In the patients with acute onset hypoesthesia, high blood pressure, and neurological deficits were more likely to be due to AIS than other causes. Since most of the lesions in AIS patients with hypoesthesia as the initial symptom were found to be small, we recommend performing MRI scans with such patients to confirm AIS.

摘要

本研究旨在评估以感觉减退为首发症状的急性缺血性脑卒中(AIS)患者的临床特征。我们回顾性分析了176例符合纳入和排除标准的住院AIS患者的病历,评估了他们的临床特征和MRI表现。在该队列中,20例(11%)患者以感觉减退为首发症状。这20例患者的MRI扫描显示,14例在丘脑或脑桥被盖部有病变,6例在其他部位有脑病变。与无感觉减退的患者相比,这20例感觉减退患者入院时收缩压( = 0.031)和舒张压( = 0.037)更高,小血管闭塞发生率更高( < 0.001)。感觉减退患者的平均住院时间明显更短( = 0.007),但入院时美国国立卫生研究院卒中量表评分( = 0.182)或出院时改良Rankin量表神经功能残疾评分与无感觉减退的患者相比无显著差异( = 0.319)。在急性起病且有感觉减退的患者中,高血压和神经功能缺损更可能是由AIS而非其他原因引起的。由于以感觉减退为首发症状的AIS患者中大多数病变较小,我们建议对这类患者进行MRI扫描以确诊AIS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/358d/10052980/10516953bf4b/neurolint-15-00030-g001.jpg

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