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大脑后动脉丘脑穿通动脉梗死的临床回顾与分析

Clinical review and analysis of artery of Percheron infarction.

作者信息

Li Jing, Ge Junling, Yang Shuhui, Yao Guoen

机构信息

Departments of Neurology, the Frist center of Chinese PLA General Hospital, China.

Departments of Radiology, Chinese PLA General Hospital, 51 Fucheng road, Haidian District, 100048 Beijing, China.

出版信息

IBRO Neurosci Rep. 2023 May 27;15:17-23. doi: 10.1016/j.ibneur.2023.04.006. eCollection 2023 Dec.

Abstract

Artery of Percheron infarction is a rare one of the neurovascular structure variants of acute ischemic stroke characterized by bilateral paramedian thalamic infarcts (BTPI), with or without mesencephalic infarction. Due to the low occurrence rate and various clinical manifestations, the early diagnosis of this disease is often missed. In addition, it is also difficult to diagnose this disease in an early implementation phase because cranial imaging and intracranial vascular imaging may show negative results. So far, its clinical cases have been rarely reported. We systematically reviewed the clinical manifestations, imaging characteristics, anatomical basis, and differentiation diagnosis of the artery of Percheron infarction and reported on three patients and their clinical and radiological medical imaging characteristic findings. We found that most of the infarct lesions in patients with an AOP infraction could not be displayed within a few hours or could not be fully displayed, even the embolism events, most of which showed typical imaging lesions at late review. The decrease of transient consciousness was obvious over the course of the three patients, and the decrease of active communication was also a major feature. Among the three cases, one patient had unilateral upper eyelid ptosis and miosis; the initial symptom of another patient was dizziness; and the other person had decreased computing power after infarction. These clinical symptoms are easily ignored in the diagnosis and treatment of patients with AOP infarction. Therefore, reporting the three clinical cases mentioned above will provide assistance for subsequent research by increasing clinical data.

摘要

大脑后动脉丘脑穿通支梗死是急性缺血性卒中罕见的神经血管结构变异类型,其特征为双侧丘脑旁正中梗死(BTPI),可伴有或不伴有中脑梗死。由于其发病率低且临床表现多样,该病早期常易漏诊。此外,在疾病早期阶段也难以诊断,因为头颅影像学和颅内血管成像可能显示阴性结果。迄今为止,其临床病例报道很少。我们系统回顾了大脑后动脉丘脑穿通支梗死的临床表现、影像学特征、解剖学基础及鉴别诊断,并报告了3例患者及其临床和放射医学影像学特征性表现。我们发现,大脑后动脉丘脑穿通支梗死患者的梗死灶大多在数小时内无法显示或不能完全显示,即使是栓塞事件,大多在后期复查时才显示出典型的影像学病灶。3例患者意识水平均有明显的短暂下降,主动交流减少也是主要特征。3例中,1例患者出现单侧上睑下垂及瞳孔缩小;另1例患者首发症状为头晕;还有1例患者梗死发生后计算能力下降。这些临床症状在大脑后动脉丘脑穿通支梗死患者的诊治中容易被忽视。因此,报告上述3例临床病例将通过增加临床数据为后续研究提供帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa81/10776326/44b4590dff02/gr1.jpg

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