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急性缺血性脑卒中伴严重颈内动脉狭窄患者行走时前额叶皮质的氧合作用:病例报告。

Prefrontal Cortex Oxygenation During Walking in an Acute Ischaemic Stroke Patient with Severe Internal Carotid Artery Stenosis: A Case Report.

机构信息

Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan.

Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan.

出版信息

Adv Exp Med Biol. 2024;1463:179-184. doi: 10.1007/978-3-031-67458-7_30.

Abstract

This study investigated the oxygenation in the prefrontal cortex (PFC) during walking in a 75-year-old male patient in the acute phase of a left frontal lobe cerebral infarction complicated by severe left internal carotid artery stenosis. The patient regained independent ambulation on the fifth day after the onset of symptoms, and the study was conducted on the eighth day after the onset of symptoms. The patient rested for 10 s before walking for 70 s. Then he rested for 60 s. The levels of oxyhaemoglobin (OHb), deoxyhaemoglobin (HHb), and total haemoglobin (THb) in the PFC were quantified during the rest and walking phases using a wearable near-infrared spectroscopy device. Comparative analysis with baseline values during rest revealed decreases in the OHb, HHb, and THb in both hemispheres of the PFC during walking (OHb: -19.76/ -14.88 μmol/L, HHb: -1.18/ -2.00 μmol/L, THb: -20.96/ -16.88 μmol/L, right/left, respectively). The recovery of the OHb was delayed by 15.8 seconds in the affected hemisphere. These findings support the effectiveness of wearable NIRS for the evaluation of cerebral oxygenation during rehabilitation in patients with acute stroke to facilitate evaluations and individualise patient care.

摘要

本研究调查了一名 75 岁男性患者在左额叶大脑梗死急性期合并严重左颈内动脉狭窄时行走过程中前额叶皮层 (PFC) 的氧合情况。该患者在症状发作后第 5 天恢复了独立行走能力,研究于症状发作后第 8 天进行。患者在行走前休息 10 秒,行走 70 秒,然后休息 60 秒。使用可穿戴近红外光谱仪设备在休息和行走阶段定量测量 PFC 中的氧合血红蛋白 (OHb)、脱氧血红蛋白 (HHb) 和总血红蛋白 (THb) 水平。与休息时的基线值进行比较分析,发现行走时 PFC 两侧的 OHb、HHb 和 THb 均降低(OHb:-19.76/-14.88μmol/L,HHb:-1.18/-2.00μmol/L,THb:-20.96/-16.88μmol/L,右侧/左侧)。患侧的 OHb 恢复延迟了 15.8 秒。这些发现支持可穿戴近红外光谱仪在评估急性脑卒中患者康复期间脑氧合方面的有效性,以促进评估和个体化患者护理。

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