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[小脑梗死的临床与演变方面]

[Clinical and evolutive aspects of cerebellar infarction].

作者信息

Onnient Y, Mihout B, Guegan-Massardier E, Samson M

机构信息

Service de Neurologie, CHU de Rouen.

出版信息

Rev Neurol (Paris). 1994;150(3):209-15.

PMID:7863166
Abstract

This study included 125 cases of cerebellar infarction followed during an average period of 4.3 years. The diagnosis was made by CT or MRI. Infarctions localized to the territory of the superior cerebellar artery (SCA) and the territory of the posterior inferior cerebellar artery (PICA) occurred with the same frequency. Transient ischemic attacks preceded infarction in 26% of cases. Symptoms and signs were usual with sudden association of headache, dizziness, unsteadiness and vomiting. Vestibular signs were more important in infarctions of the PICA territory; cerebellar signs and dysarthria were more frequent in infarction of the SCA territory. A decreased level of consciousness developed in only 21% of cases. Surgical operation was required in 9 cases. Investigations have showed the large responsibility of cardiac embolisms and atherosclerosis. Short term outcome was more often favourable: 116 patients were alive at the end of the first month; 80% of survivors were independent one year later. At 5 years, 73% of patients were alive. After the acute period, mortality was mainly due to cerebro-vascular and cardiac events.

摘要

本研究纳入了125例小脑梗死患者,平均随访时间为4.3年。诊断通过CT或MRI做出。小脑上动脉(SCA)供血区和小脑后下动脉(PICA)供血区的梗死发生率相同。26%的病例在梗死前有短暂性脑缺血发作。症状和体征通常为突然出现头痛、头晕、共济失调和呕吐。前庭体征在PICA供血区梗死中更为重要;小脑体征和构音障碍在SCA供血区梗死中更为常见。仅21%的病例出现意识水平下降。9例患者需要手术治疗。研究表明心脏栓塞和动脉粥样硬化起了很大作用。短期预后通常较好:第一个月末116例患者存活;一年后80%的幸存者能够独立生活。5年后,73%的患者存活。急性期过后,死亡率主要归因于脑血管和心脏事件。

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