Gastaut H, Gastaut J L
Centre Hospitalier, Universitaire de Marseille, France.
Comput Tomogr. 1977;1(4):323-30. doi: 10.1016/0363-8235(77)90016-3.
Among 500 epileptic patients studied by Computerized Tomography, 11 patients presented an occipital porencephaly (or a dilation of the occipital horn with a "porencephalic" aspect) sometimes associated with a ventricular dilation. These 11 patients represented 2.2% of our patients and 5% of those less than 20 yr of age which is frequent in relation to lesions of the same type having a different topography. Clinical and EEG studies of these 11 patients revealed hemiplegia or hemiparesis in 8 cases, hemianopsia in 7 cases, a severe partial epilepsy in 6 cases which was temporal in 5 patients, a secondary generalized epilepsy in 3 cases, and an epilepsy unable to be classified in 2 cases. The "porencephalies" responsible for these clinical signs are most likely of encephalomalacic origin, secondary to circulatory troubles in the peri- or postnatal period. Remillard et al. maintain that perinatal occlusion of the posterior cerebral artery is responsible. However, in our personal series, the results obtained from CT, PEG and angiography do not permit us to be as affirmative as to the vascular etiology responsible.
在通过计算机断层扫描研究的500例癫痫患者中，11例出现枕叶脑穿通畸形（或枕角扩张并呈现“脑穿通畸形”外观），有时伴有脑室扩张。这11例患者占我们研究患者的2.2%，占20岁以下患者的5%，相对于具有不同部位的同类型病变而言较为常见。对这11例患者的临床和脑电图研究显示，8例出现偏瘫或轻偏瘫，7例出现偏盲，6例出现严重部分性癫痫（其中5例为颞叶癫痫），3例出现继发性全身性癫痫，2例癫痫无法分类。导致这些临床症状的“脑穿通畸形”很可能源于脑软化，继发于围产期或产后的循环系统问题。雷米拉德等人认为是大脑后动脉围产期闭塞所致。然而，在我们的个人系列研究中，计算机断层扫描、脑池造影和血管造影的结果并不足以让我们对其血管病因如此肯定。
