Mamoli B, Dal Bianco P, Zeiler K, Wessely P
Wien Klin Wochenschr. 1980 Dec 19;92(24):862-8.
The results are presented of angiographic investigations in 85 patients suffering from transient ischaemic cerebral circulatory disturbances. Transient ischaemic attacks (TIA) were observed in 45 patients, reversible ischaemic neurological defects of longer duration (PRIND) were diagnosed in 40 patients. The mean age of all patients at the time of angiography was 49.9 years. Transfemoral cerebral panarteriography was performed in all cases, including studies both of the aortic arch and of the cranio-cervical vessels. The mean interval between the first manifestation of cerebrovascular disease and angiographic investigation was approximately 2 years. 10.6% of all patients showed normal angiograms; in 35.3% of all cases diffuse vessel wall alterations were found; 37.6% showed minor stenoses (vessel diameter reduced to 80-34%), whilst 16.5% showed major stenoses (vessel diameter reduced to 33-1%) or occlusions. There was poor correlation between clinical-neurological localization of the ischaemic lesion and the angiographically-verified stenoses or occlusions. The angiographic findings corresponded to the clinically affected regions in only 52.2% of all patients suffering from stenoses of occlusions. A good correlation was found in 71.4% of the cases when only major stenoses and occlusions were evaluated. Consequently, angiographic studies of the aortic arch, as well as of all extra- and intracranial vessels are a precondition for the surgical treatment of the cranio-cervical vessels in every patient. It is possible by these means only to achieve a comprehensive assessment of the haemodynamic processes in the cerebral circulation.
本文呈现了85例患有短暂性脑缺血循环障碍患者的血管造影检查结果。45例患者出现短暂性脑缺血发作(TIA),40例患者被诊断为持续时间较长的可逆性缺血性神经功能缺损(PRIND)。所有患者在进行血管造影时的平均年龄为49.9岁。所有病例均进行了经股动脉全脑血管造影,包括对主动脉弓和颅颈血管的研究。脑血管疾病首次出现至血管造影检查的平均间隔时间约为2年。10.6%的患者血管造影显示正常;35.3%的病例发现弥漫性血管壁改变;37.6%显示轻度狭窄(血管直径缩小至80 - 34%),而16.5%显示重度狭窄(血管直径缩小至33 - 1%)或闭塞。缺血性病变的临床神经定位与血管造影证实的狭窄或闭塞之间相关性较差。在所有患有狭窄或闭塞的患者中,血管造影结果仅在52.2%的患者中与临床受累区域相符。当仅评估重度狭窄和闭塞时,71.4%的病例发现有良好的相关性。因此,对主动脉弓以及所有颅外和颅内血管进行血管造影研究是对每位患者颅颈血管进行手术治疗的前提条件。只有通过这些方法才能全面评估脑循环中的血流动力学过程。