Mohr J P, Foulkes M A, Polis A T, Hier D B, Kase C S, Price T R, Tatemichi T K, Wolf P A
Neurological Institute of New York Columbia-Presbyterian Medical Center, NY 10032.
J Neurol Neurosurg Psychiatry. 1993 Apr;56(4):344-51. doi: 10.1136/jnnp.56.4.344.
For the 183 of 1276 patients in the NINDS Stroke Data Bank with convexity infarction in the middle cerebral artery territory, the size of the infarct did not differ between the two sides but the location of the main site of the infarct differed: on the left side, it was centred in the inferior parietal region, and was mid-frontal on the right. There was a good correlation between infarct size and weakness severity whether estimated by overall motor function on one side, arm, or hand alone. There was a poor correlation, however, for lesion location (lower third, middle third or upper third on either side of the Rolandic fissure) and any of the specific syndromes of focal weakness, no two cases sharing the same lesion for the same syndrome and several cases sharing the same lesion with a different syndrome. The findings indicated a difference in weakness syndromes between the two hemispheres and great individual variation of the acute syndrome caused by a given site of focal infarction along the Rolandic convexity. These variations may explain some of the difficulties showing effects of a given therapeutic agent in studies of acute ischaemic stroke. Large sample sizes will be required for the reliable assessment of any treatment using currently popular clinical stroke scales.
在国立神经疾病与中风研究所（NINDS）中风数据库的1276例患者中，有183例在大脑中动脉区域发生凸面梗死，梗死大小在两侧并无差异，但梗死主要部位的位置有所不同：左侧以顶叶下部区域为中心，右侧则位于额中部。无论是通过一侧的整体运动功能、单独的手臂或手部来评估，梗死大小与无力严重程度之间都存在良好的相关性。然而，病变位置（中央沟两侧的下三分之一、中三分之一或上三分之一）与任何局灶性无力的特定综合征之间的相关性较差，没有两例相同综合征的病例具有相同的病变，且有几例不同综合征的病例具有相同的病变。这些发现表明，两个半球的无力综合征存在差异，并且由罗兰凸面特定局灶性梗死部位引起的急性综合征存在很大的个体差异。这些差异可能解释了在急性缺血性中风研究中显示特定治疗药物效果时遇到的一些困难。使用目前流行的临床中风量表对任何治疗进行可靠评估都需要大样本量。
