Obara K, Meyer J S, Muramatsu K, Mortel K F
Cerebral Blood Flow Laboratories, Department of Veterans Affairs Medical Center, Houston, TX 77030, USA.
Neurol Res. 1995 Oct;17(5):377-83.
This investigation was designed to clarify the chronic effects of cardiogenic emboli on cerebral perfusion and tissue densities within remaining noninfarcted brain. Local cerebral perfusion and tissue densities were measured by xenon-contrasted CT scanning and compared by cross-sectional designs among normal volunteers without heart disease (Group C, n = 44), normal volunteers with heart disease (Group N, n = 20), patients with heart disease and lacunar infarctions (Group L, n = 31) and patients with heart disease associated with cardiogenic cerebral embolism (Group E, n = 12). In Group E, remaining cortical and subcortical gray and white matter perfusion were reduced compared to Groups C and N (p = 0.01), but did not differ from Group L, who had similar profiles of risk factor for stroke. In Group E, perfusion was reduced within the thalamus ipsilateral to cortical infarctions (p < 0.05). There were no differences in remaining tissue densities between Groups E and L. It is concluded that reduced cerebral perfusion in noninfarcted regions among patients with cardiogenic emboli appears to be related to atherosclerosis of small cerebral vessels in a similar manner to patients with lacunes, but thalamo-cortical disconnections also contribute to cerebral hypoperfusion.
本研究旨在阐明心源性栓子对脑灌注及剩余未梗死脑区组织密度的慢性影响。通过氙增强CT扫描测量局部脑灌注和组织密度，并采用横断面设计对无心脏病的正常志愿者（C组，n = 44）、有心脏病的正常志愿者（N组，n = 20）、患有心脏病和腔隙性脑梗死的患者（L组，n = 31）以及患有心源性脑栓塞的心脏病患者（E组，n = 12）进行比较。与C组和N组相比，E组剩余皮质和皮质下灰质及白质灌注减少（p = 0.01），但与L组无差异，L组具有相似的中风危险因素特征。在E组中，与皮质梗死同侧的丘脑灌注减少（p < 0.05）。E组和L组之间剩余组织密度无差异。得出的结论是，心源性栓子患者未梗死区域脑灌注降低似乎与腔隙性脑梗死患者一样，与脑小血管动脉粥样硬化有关，但丘脑 - 皮质连接中断也会导致脑灌注不足。
