Chaves C J, Caplan L R, Chung C S, Tapia J, Amarenco P, Teal P, Wityk R, Estol C, Tettenborn B, Rosengart A
Department of Neurology, New England Medical Center, Tufts University, Boston, MA 02111.
Neurology. 1994 Aug;44(8):1385-90. doi: 10.1212/wnl.44.8.1385.
We report the clinical findings and stroke mechanisms of 63 patients with cerebellar infarcts. We divided the intracranial vertebrobasilar circulation into the proximal territory (P), fed by the intracranial vertebral arteries and their branches; the middle territory (M), fed by the proximal and middle basilar artery and its branches; and the distal territory (D), fed by the rostral basilar artery and its branches. Cerebellar infarcts were classified by vascular territories P, M, D, P&D, and middle-plus (P&M, M&D, and P&M&D). Patients with P infarcts (11 patients) frequently had vertigo, gait instability, limb ataxia, and headache, whereas patients with D infarcts (15 patients) most often had limb ataxia, gait instability, and dysarthria. Patients with P&D infarcts (17 patients) had signs and symptoms of both groups combined. Infarcts in which the middle territory was involved, either alone (three patients) or combined with other territories (17 patients) were dominated by brainstem signs and symptoms. The predominant stroke mechanisms in the P, D, and P&D groups were embolic due to intra-arterial or cardiac embolism. When the M territory was involved, either alone or with P, D, or P&D territories, stroke mechanisms were more varied, and there was often large-artery occlusion with hemodynamic ischemia.
我们报告了63例小脑梗死患者的临床发现及卒中机制。我们将颅内椎基底循环分为近端区域（P），由颅内椎动脉及其分支供血；中间区域（M），由近端和中间基底动脉及其分支供血；以及远端区域（D），由基底动脉头端及其分支供血。小脑梗死按血管区域分为P、M、D、P&D以及中间加型（P&M、M&D和P&M&D）。P区域梗死患者（11例）常出现眩晕、步态不稳、肢体共济失调和头痛，而D区域梗死患者（15例）最常出现肢体共济失调、步态不稳和构音障碍。P&D区域梗死患者（17例）具有两组症状和体征的综合表现。中间区域单独受累的梗死患者（3例）或与其他区域合并受累的梗死患者（17例）以脑干症状和体征为主。P、D和P&D组的主要卒中机制是动脉内或心脏栓塞所致的栓塞。当M区域单独受累或与P、D或P&D区域合并受累时，卒中机制更多样化，且常出现大动脉闭塞伴血流动力学缺血。
