Brandt T, Thie A, Caplan L R, Hacke W
Neurologische Universitätsklinik Heidelberg.
Nervenarzt. 1995 Apr;66(4):267-74.
The clinical and neuroradiological features of 127 patients with ischemia of the posterior cerebral artery (PCA) and a positive CT scan (n = 122) or pathological angiography findings (n = 63) were analyzed. Unilateral headache was the most common presenting symptom (50%), making complicated migraine an important differential diagnosis. Clinical findings were visual field deficits (93%), sensory (29%), motor (28%), and neuropsychological deficits (25%). Infarcts, including the thalamus (n = 27), were mostly associated with sensory and slight motor deficits. Our findings suggest that motor deficits in PCA ischemia, particularly if minor and reversible, are likely to be due to ischemia-induced edema in the internal capsule adjacent to an associated thalamic infarct. Based on angiography, stroke etiology was considered embolic in 83/127 (65%), atherothrombotic in 20/126 (16%), and probably migrainous in 4 (3%) patients. In the remaining 20 patients (16%), the etiology was uncertain. Prognosis of PCA infarcts is usually good.
对127例大脑后动脉（PCA）缺血且CT扫描阳性（n = 122）或血管造影病理结果阳性（n = 63）患者的临床和神经放射学特征进行了分析。单侧头痛是最常见的首发症状（50%），这使得复杂性偏头痛成为重要的鉴别诊断。临床发现包括视野缺损（93%）、感觉（29%）、运动（28%）和神经心理学缺损（25%）。梗死灶，包括丘脑梗死（n = 27），大多与感觉和轻度运动缺损相关。我们的研究结果表明，PCA缺血导致的运动缺损，尤其是轻微且可逆的运动缺损，可能是由于与相关丘脑梗死相邻的内囊缺血性水肿所致。根据血管造影，83/127（65%）例患者的卒中病因被认为是栓塞性的，20/126（16%）例是动脉粥样硬化血栓形成性的，4例（3%）患者可能是偏头痛性的。其余20例患者（16%）病因不明。PCA梗死的预后通常良好。
