Mauch E, Mayer G, Kornhuber A, Krapf H, Jürgens R, Hufnagl J M, Kornhuber H H
Abteilung Neurologie, Universität Ulm.
Rehabilitation (Stuttg). 1994 Nov;33(4):212-20.
The courses of 118 patients who had suffered a supratentorial ischaemic infarction were observed over a mean follow-up period of 4 years. One goal of this study was to assess the prognostic value of quantitative cranial computerized tomography (CT). The infarct volume was determined using CT and expressed quantitatively as a percentage of the total brain volume. The infarct volume correlated negatively with the global outcome as estimated by the Barthel Index. It correlated positively with the occurrence of psychiatric alterations, disturbances of consciousness or alterations in the EEG. Nicotine, alcohol consumption and hyperuricaemia were the most frequent risk factors identified for men, while for women, especially those over 60, cardiac diseases were the most relevant risk factors. In looking only at the older patients, age, psychiatric alterations and cardiac disease at the time of the stroke were unfavourable prognostic factors. CT lesions in the basal ganglia were also unfavourable prognostic factors. Infarcts in the posterior cerebral artery region were seen as prognostically favourable. During the 4-year follow-up period, the reinfarction rate was 26%. Nearly 50% of the total patient population died. This group was significantly older, had more psychiatric alterations as well as multiple infarct areas in CT.
对118例幕上缺血性梗死患者的病程进行了观察，平均随访期为4年。本研究的一个目标是评估定量头颅计算机断层扫描（CT）的预后价值。使用CT确定梗死体积，并以占全脑体积的百分比进行定量表示。梗死体积与Barthel指数评估的总体预后呈负相关。它与精神障碍、意识障碍或脑电图改变的发生呈正相关。尼古丁、饮酒和高尿酸血症是男性最常见的危险因素，而对于女性，尤其是60岁以上的女性，心脏病是最相关的危险因素。仅观察老年患者时，中风时的年龄、精神障碍和心脏病是不良预后因素。基底节区的CT病变也是不良预后因素。大脑后动脉区域的梗死被视为预后良好。在4年的随访期内，再梗死率为26%。几乎50%的患者死亡。该组患者年龄明显更大，有更多的精神障碍，且CT显示有多个梗死区域。
