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[一项关于大脑后动脉区域82例脑梗死的研究]

[A study of 82 cerebral infarctions in the area of posterior cerebral arteries].

作者信息

Milandre L, Brosset C, Botti G, Khalil R

机构信息

Service de Neurologie, CHU de la Timone, Marseille.

出版信息

Rev Neurol (Paris). 1994;150(2):133-41.

PMID:7863153
Abstract

Of 598 consecutive non-selected cases of cerebral infarction included in a stroke registry, 82 cases (54 men and 28 women, mean age 66 +/- 14 years) of spontaneous and isolated posterior cerebral artery (PCA) territory infarction (right PCA in 36, left PCA in 35 and both in 11) were identified on the basis of CT combined with MRI in 51 cases. Infarction was superficial in 25 (group A), combined deep-superficial in 23 (group B) and deep in 34 (group C). Of 48 superficial lesions, 29 were massive while 19 were restricted to the territory of one branch. Of 57 deep lesions, 21 were located in the inferolateral thalamic territory, 10 in the paramedian thalamic territory, 12 in other midbrain or thalamic territories, and 14 in a combination of various midbrain and/or thalamic territories. Of 41 patients with unilateral superficial involvement, 39 had homonymous visual field defect. Unawareness of the visual defect and visual release hallucinations were observed with the same frequency in right and left lesions. Of 7 patients with bilateral superficial involvement, only 5 had bilateral visual field defect including incomplete cortical blindness in 3. The frequency of confusional state (n = 24) did not differ significantly in left versus right sided lesions while it was significantly higher in superficial or combined versus deep lesions (p = 0.05). Of 18 clinically evaluable patients with left PCA territory infarct, 14 had speech disorders including pure alexia in only one case. Of 15 patients with right territory infarction, 10 had spatial judgement disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在一个卒中登记处纳入的598例连续非选择性脑梗死病例中,通过CT联合MRI在51例中确定了82例(54例男性和28例女性,平均年龄66±14岁)自发性孤立性大脑后动脉(PCA)区域梗死(右侧PCA梗死36例,左侧PCA梗死35例,双侧梗死11例)。梗死为浅表性的有25例(A组),深部-浅表性联合的有23例(B组),深部的有34例(C组)。48例浅表性病变中,29例为大面积病变,19例局限于一个分支区域。57例深部病变中,21例位于丘脑下外侧区域,10例位于丘脑旁正中区域,12例位于其他中脑或丘脑区域,14例位于多种中脑和/或丘脑区域的组合。41例单侧浅表性受累患者中,39例有同向性视野缺损。右侧和左侧病变中视觉缺损失认和视幻觉的发生率相同。7例双侧浅表性受累患者中,仅5例有双侧视野缺损,其中3例为不完全皮质盲。意识模糊状态(n = 24)在左侧和右侧病变中的发生率无显著差异,而在浅表性或联合性病变与深部病变相比中显著更高(p = 0.05)。18例可进行临床评估的左侧PCA区域梗死患者中,14例有言语障碍,仅1例为纯失读症。15例右侧区域梗死患者中,10例有空间判断障碍。(摘要截短至250字)

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