Giroud M, Fayolle H, André N, Essayagh E, Menassa M, Milan C, Dumas R
Registre Dijonnais des Accidents Vasculaires Cérébraux, (INSERM/D.G.S.), CHU, Dijon.
Rev Neurol (Paris). 1994 Dec;150(12):840-3.
To evaluate the prevalence, the aetiological profile and the neurological consequences at day 15 of a transient ischaemic attack (TIA) before a cerebral infarction, we undertook survey from 1985 to 1991, on 1,149 cases with cerebral infarction observed on the population of Dijon. On 1,149 cases, 275 (24%) were preceded by a TIA. Fifty seven cases were lacunar infarcts (20.7%) and 218 were cortical infarcts (79.3%). On the aetiological point of view, the group with 275 infarctions preceded by a TIA was statistically different from the group of 874 infarctions without any TIA, with higher blood pressure, cardiac arrhythmia, tobacco abuse and ischaemic cardiac disease history. Only 65 out of 275 infarctions preceded by one TIA (23.6%) had a perfect territorial relationship between the 2 attacks, and 210 out of 275 (76.4%) had no territorial relationship. While the Barthel score at day 15 was similar within the 2 groups, inversely, pseudo-bulbar syndrome was significantly more frequent in the first group. Former TIA does not increase the general handicap resulting from a cerebral infarct, nevertheless it gives rise to a pseudo-bulbar syndrome.
为评估脑梗死前短暂性脑缺血发作(TIA)第15天时的患病率、病因学特征及神经学后果,我们于1985年至1991年对第戎地区人群中观察到的1149例脑梗死患者进行了调查。在这1149例患者中,275例(24%)之前有过TIA。其中57例为腔隙性梗死(20.7%),218例为皮质梗死(79.3%)。从病因学角度来看,275例梗死前有TIA的患者组与874例无TIA的梗死患者组在统计学上存在差异,前者有更高的血压、心律失常、吸烟史和缺血性心脏病史。在275例有一次TIA的梗死患者中,只有65例(23.6%)两次发作之间存在完美的区域关系,275例中有210例(76.4%)不存在区域关系。虽然两组在第15天时的Barthel评分相似,但相反,假性延髓麻痹综合征在第一组中明显更常见。既往TIA并不会增加脑梗死导致的总体残疾程度,不过会引发假性延髓麻痹综合征。