Nighoghossian N, Ryvlin P, Trouillas P, Laharotte J C, Froment J C
Department of Neurology and Cerebrovascular Disease, Neurological Hospital, Lyon, France.
Neurology. 1993 Nov;43(11):2197-201. doi: 10.1212/wnl.43.11.2197.
We prospectively studied 21 patients with pure motor hemiparesis (PMH). CT showed a capsular lesion consistent with the clinical syndrome in 15 patients (71%) and was repeatedly negative in the remaining six (29%). In all six patients with repeatedly negative CT, MRI showed a pontine paramedian infarct as the notable cause of PMH. Clinical findings could not definitely distinguish between capsular and pontine PMH, but the combination of dysarthria and a history of previous transient gait abnormality or vertigo favored a pontine location. Outcome at 3 months was characterized by persistent, moderate to severe disability in 86% of patients with pontine PMH versus 46% in capsular PMH. Based on MRI and magnetic resonance angiographic findings, the presumed mechanism of pontine ischemic lesions was a lacunar process in most instances (86%).
我们前瞻性地研究了21例纯运动性偏瘫（PMH）患者。CT显示，15例患者（71%）存在与临床综合征相符的囊腔病变，其余6例（29%）的CT检查结果反复为阴性。在CT检查结果反复为阴性的所有6例患者中，MRI显示脑桥旁正中梗死是PMH的显著病因。临床检查结果无法明确区分囊腔性和脑桥性PMH，但构音障碍与既往短暂性步态异常或眩晕病史相结合提示病变更倾向于脑桥部位。3个月时的结果显示，脑桥性PMH患者中有86%持续存在中度至重度残疾，而囊腔性PMH患者中的这一比例为46%。根据MRI和磁共振血管造影结果，在大多数情况下（86%），脑桥缺血性病变的推测机制为腔隙性病变。
