Tarvonen-Schröder S, Röyttä M, Räihä I, Kurki T, Rajala T, Sourander L
Department of Geriatrics, University of Turku, Finland.
J Neurol Neurosurg Psychiatry. 1996 Apr;60(4):431-6. doi: 10.1136/jnnp.60.4.431.
To study the clinical features of leuko-araiosis.
Age matched groups of patients with a CT finding of pure leukoaraiosis (n = 26) and a control group with a normal CT finding (n = 26) were formed (mean ages 78.6 (SD 3.3) v 76.5 (SD 4.6) years; NS).
Dementia, vascular dementia, central brain atrophy on CT, disability in activities of daily living and instrumental activities of daily living, urinary incontinence, gait disorder (assistance needed), personality change, and night time confusion were found to be more commonly present in leuko-araiosis positive patients than in controls, whereas focal neurological symptoms and signs were not associated with leuko-araiosis. The occurrences of heart failure and systolic hypotension-but not hypertension-were higher in the leuko-araiosis positive group than in the controls. Leuko-araiosis was also found to be related to a less sudden onset of symptoms and a lower Hachinski score than true brain infarction(s).
Leuko-araiosis on CT in these elderly patients seems to be a vascular disorder aetiologically different from brain infarction, with clinical manifestations of subtle onset and general disabling nature and no prominent focal neurological signs or symptoms.
研究脑白质疏松症的临床特征。
选取CT检查结果为单纯脑白质疏松症的患者(n = 26)与CT检查结果正常的对照组(n = 26),两组年龄匹配(平均年龄分别为78.6(标准差3.3)岁和76.5(标准差4.6)岁;无显著差异)。
发现脑白质疏松症阳性患者比对照组更常出现痴呆、血管性痴呆、CT显示的脑萎缩、日常生活活动和工具性日常生活活动能力丧失、尿失禁、步态障碍(需要辅助)、性格改变和夜间意识模糊,而局灶性神经症状和体征与脑白质疏松症无关。脑白质疏松症阳性组心力衰竭和收缩期低血压(而非高血压)的发生率高于对照组。还发现脑白质疏松症与症状发作较不突然以及哈金斯基评分低于真正的脑梗死有关。
这些老年患者CT上的脑白质疏松症似乎是一种病因上不同于脑梗死的血管疾病,具有起病隐匿和导致全身功能障碍的临床表现,且无明显的局灶性神经体征或症状。