Derouesné C, Cambon H, Yelnik A, Duyckaerts C, Hauw J J
Department of Neurology N. 3, Hôpital de la Salpêtrière, Paris, France.
Acta Neurol Scand. 1993 May;87(5):361-6. doi: 10.1111/j.1600-0404.1993.tb04118.x.
Correlates of the size of infarcts, the time from stroke to death, and the mechanisms of death were studied in 77 consecutive patients who died from infarction in the middle cerebral artery territory. The area of infarcts was assessed by planimetry on schemas of representative brain levels and the results were expressed as a ratio of infarcted area on the whole MCA territory. No clear relationship was found between the size of infarcts in the MCA territory, and any of the characteristics of the patients, but extensive infarcts were more frequent when the internal carotid artery was occluded. No evidence was found of an adverse effect of age, diabetes or initial hyperglycemia on the size of infarcts. The mechanisms of death were not linked to sex, age, high blood pressure, diabetes, blood glucose level at admission, presence and location of an arterial occlusion, or etiology of the infarct. On the contrary, they varied as a function of interval from stroke to death. Transtentorial herniation, the main cerebral cause of death, occurred mainly in the first week and was related to the large size of infarcts. Rare recurrences of stroke and frequent extracerebral mechanisms of death (mainly pneumonia, pulmonary embolism and cardiopathy) occurred later on.
对77例死于大脑中动脉区域梗死的连续患者，研究了梗死灶大小、卒中至死亡时间及死亡机制之间的相关性。通过对代表性脑层面的模式图进行面积测量来评估梗死灶面积，结果以梗死面积占整个大脑中动脉区域的比例表示。未发现大脑中动脉区域梗死灶大小与患者的任何特征之间存在明确关系，但当颈内动脉闭塞时，广泛梗死更为常见。未发现年龄、糖尿病或初始高血糖对梗死灶大小有不良影响。死亡机制与性别、年龄、高血压、糖尿病、入院时血糖水平、动脉闭塞的存在及部位或梗死病因无关。相反，它们随卒中至死亡的时间间隔而变化。小脑幕切迹疝是主要的脑部死亡原因，主要发生在第一周，且与梗死灶大有关。卒中罕见复发及常见的脑外死亡机制（主要是肺炎、肺栓塞和心脏病）在后期出现。
