Luijckx G J, Boiten J, Lodder J, Heuts-van Raak L, Wilmink J
Department of Neurology, University Hospital Maastricht, State University of Limburg, The Netherlands.
J Neurol Neurosurg Psychiatry. 1994 Jun;57(6):742-4. doi: 10.1136/jnnp.57.6.742.
Acute isolated hemiataxia is in most cases due to infratentorial (cerebellar) stroke. It has only twice been described in supratentorial stroke--namely, after thalamic infarction and a capsular haemorrhage. Three patients with isolated hemiataxia after a supratentorial brain infarct are described. These patients were seen in a period of five years during which 899 patients with a first supratentorial brain infarct were registered. Clinically the hemiataxia was of the cerebellar type. In two patients, CT and MRI showed a small, deep (lacunar) infarct restricted to the posterior limb of the internal capsule, a site not previously reported in isolated hemiataxia. The third patient had a small, deep (lacunar) infarct in the thalamus extending into the adjacent posterior limb of the internal capsule. Isolated hemiataxia after a supratentorial brain infarct is a very rare clinical stroke syndrome. The cerebellar type hemiataxia was most likely caused by interruption of the cerebellar pathways at the level of the internal capsule. Our cases confirm prior observations that the cerebellar pathways run through the posterior part of the posterior limb of the internal capsule separately from the motor and sensory pathways.
急性孤立性偏身共济失调在大多数情况下是由于幕下（小脑）卒中所致。仅有两次报道称其出现在幕上卒中后，即丘脑梗死和脑桥出血后。本文描述了3例幕上脑梗死继发孤立性偏身共济失调的患者。这些患者是在5年期间内见到的，在此期间共登记了899例首次发生幕上脑梗死的患者。临床上，偏身共济失调为小脑型。2例患者的CT和MRI显示，局限于内囊后肢的小而深的（腔隙性）梗死灶，这一部位此前未见有孤立性偏身共济失调的报道。第3例患者丘脑有一个小而深的（腔隙性）梗死灶，并延伸至相邻的内囊后肢。幕上脑梗死继发孤立性偏身共济失调是一种非常罕见的临床卒中综合征。小脑型偏身共济失调很可能是由于内囊水平的小脑传导通路中断所致。我们的病例证实了之前的观察结果，即小脑传导通路穿过内囊后肢的后部，与运动和感觉传导通路分开。
