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多发性梗死性痴呆的步态障碍。CT与临床相关性

Gait disorders of multi-infarct dementia. CT and clinical correlation.

作者信息

Thajeb P

机构信息

Section of Neurology, Cathay General Hospital, Taipei, Taiwan, ROC.

出版信息

Acta Neurol Scand. 1993 Mar;87(3):239-42. doi: 10.1111/j.1600-0404.1993.tb04109.x.

Abstract

Twenty-five patients with various types of gait disorders of multi-infarct dementia (MID) were reported. The types of gait disorders consisted of lower body parkinsonism (LBP) plus ataxia (6 patients), LBP plus apraxia (5 patients), and a combination of LBP plus ataxia and apraxia (14 patients). Hypertension occurred in 23 (92%) of the 25 patients. Nevertheless, individual stroke risk factors and the locations of infarcts were not significantly different between the subgroups. Ventriculomegaly and "leuko-araiosis" as demonstrated by computed tomography occurred in more than 80% of patients in each subgroup. Atrophy of the superior vermis was seen in 16 (80%) of 20 patients with ataxia as compared to 2 (40%) of the 5 patients without ataxia (p < 0.005). These data suggest that LBP and apraxia of MID were probably determined by the presence of ventriculomegaly or leuko-araiosis or both, and the presence of ataxic component of gait disorder most probably indicates the presence of vermian atrophy.

摘要

报告了25例患有多种类型多梗死性痴呆(MID)步态障碍的患者。步态障碍类型包括下体帕金森综合征(LBP)加共济失调(6例)、LBP加失用症(5例)以及LBP加共济失调和失用症的组合(14例)。25例患者中有23例(92%)患有高血压。然而,各亚组之间个体中风危险因素和梗死部位并无显著差异。计算机断层扫描显示脑室扩大和“脑白质疏松症”在每个亚组中超过80%的患者中出现。20例共济失调患者中有16例(80%)出现上蚓部萎缩,而5例无共济失调患者中有2例(40%)出现上蚓部萎缩(p<0.005)。这些数据表明,MID的LBP和失用症可能由脑室扩大或脑白质疏松症或两者共同存在所决定,步态障碍的共济失调成分的存在很可能表明存在蚓部萎缩。

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