Giroud M, Lemesle M, Madinier G, Billiar T, Dumas R
Service de Neurologie, Centre Hospitalo-Universitaire, Raines, Dijon, France.
J Neurol Neurosurg Psychiatry. 1997 Nov;63(5):611-5. doi: 10.1136/jnnp.63.5.611.
To analyse the clinical features induced by lenticular infarction found in 20 patients, and to analyse the radiological and clinical correlations.
Eight women and 12 men, mean age 73 years, were included in this study, which was carried out from 1 January 1994 to 30 November 1996. They were characterised by the onset of a lenticular infarction, shown by CT and MRI. A complete neurological and neurocognitive examination, and photon emission computed tomography (SPECT), were performed in all the patients and there was a long clinical follow up.
Two distinct clinical syndromes were identified corresponding to the two anatomical areas of the lenticular nucleus: behavioural and cognitive disorders were associated with infarcts within the globus pallidus, whereas both motor disorders (dystonia) and cognitive disorders were associated with infarcts within the putamen. Outcome was excellent in all the patients for motor function, but slight cognitive disorders, problems with short term memory, and dysphasia persisted for several months. The size of the lesion did not explain these symptoms. By contrast, the slight reduction in cerebral blood flow found in the adjacent frontotemporal area may explain them by a deafferentation or a diaschisis phenomenon.
It is possible to identify the clinical symptoms of a single lesion in the pallidus nucleus and in the putaminal nucleus, in which behavioural, cognitive, and movements disorders are important. After an acute and spectacular onset, outcome is in general excellent. A disease of the small arteries must be involved.
分析20例豆状核梗死所致的临床特征，并分析影像学与临床的相关性。
本研究纳入8名女性和12名男性，平均年龄73岁，研究时间为1994年1月1日至1996年11月30日。他们的特征是出现豆状核梗死，CT和MRI显示了这一点。对所有患者进行了全面的神经和神经认知检查以及单光子发射计算机断层扫描（SPECT），并进行了长期临床随访。
对应豆状核的两个解剖区域，确定了两种不同的临床综合征：行为和认知障碍与苍白球内梗死有关，而运动障碍（肌张力障碍）和认知障碍均与壳核内梗死有关。所有患者的运动功能预后均良好，但轻微的认知障碍、短期记忆问题和言语困难持续了数月。病变大小无法解释这些症状。相比之下，相邻额颞叶区域发现的脑血流量轻微减少可能通过传入神经阻滞或交叉性神经机能联系障碍现象来解释这些症状。
有可能识别苍白球核和壳核单个病变的临床症状，其中行为、认知和运动障碍很重要。在急性且明显的发病后，总体预后良好。必须涉及小动脉疾病。
