Ramadan N M, Levine S R, Welch K M
Department of Neurology, Henry Ford Hospital and Health Sciences Center, Detroit, MI 48202-2689.
Stroke. 1994 Jun;25(6):1219-22. doi: 10.1161/01.str.25.6.1219.
Transient neurological symptoms of brain stem or occipital lobe origin may be caused by transient ischemic attack in the vertebrobasilar territory (VB-TIA) or late-onset (or late-life) migraine accompaniment (LOMA). It is often clinically difficult to distinguish between VB-TIA and LOMA.
Cerebral blood flow of 23 patients with VB-TIA, 24 with LOMA, and 28 age-matched control subjects was measured using the 133Xe inhalation regional cerebral blood flow (rCBF) technique.
After adjusting for differences in baseline variables such as blood pressure, hematocrit, and PCO2, patients with VB-TIA had (1) lower mean rCBF than control subjects (P < .003) as measured by the initial slope index method; (2) more frequent anterior rCBF asymmetries than control subjects and patients with LOMA (P < .03 for both comparisons); and (3) higher mean interhemispheric rCBF differences compared with patients with LOMA (P = .08) and control subjects (P < .02).
Regional CBF patterns in patients with VB-TIA and LOMA differ, with lower rCBF and more asymmetry of the anterior blood flows in patients with VB-TIA, probably reflecting the effects of stroke risk factors on the cerebral circulation. Patients with LOMA have rCBF patterns more closely resembling those of age-matched healthy subjects. rCBF measurements may assist in the clinical diagnosis of VB-TIA and late-onset migrainous events.
脑干或枕叶起源的短暂性神经症状可能由椎基底动脉系统短暂性脑缺血发作（VB-TIA）或迟发性（或老年期）偏头痛伴发症（LOMA）引起。临床上常常难以区分VB-TIA和LOMA。
采用吸入133Xe局部脑血流量（rCBF）技术，对23例VB-TIA患者、24例LOMA患者及28例年龄匹配的对照者进行脑血流量测量。
在对血压、血细胞比容和PCO2等基线变量差异进行校正后，VB-TIA患者具有以下特点：（1）采用初始斜率指数法测量时，其平均rCBF低于对照者（P <.003）；（2）与对照者及LOMA患者相比，其前脑rCBF不对称更为常见（两项比较P均 <.03）；（3）与LOMA患者（P =.08）及对照者（P <.02）相比，其平均半球间rCBF差异更高。
VB-TIA和LOMA患者的局部脑血流量模式不同，VB-TIA患者的rCBF较低，前脑血流不对称性更高，这可能反映了中风危险因素对脑循环的影响。LOMA患者的rCBF模式更类似于年龄匹配的健康受试者。rCBF测量可能有助于VB-TIA和迟发性偏头痛事件的临床诊断。
