Uehara T, Tabuchi M, Mori E
Neurology Service, Hyogo Brain and Heart Center at Himeji.
Rinsho Shinkeigaku. 1997 Sep;37(9):796-801.
The purpose of this study is to elucidate the prevalence and degree of occlusive lesions of carotid and intracranial arteries in patients with symptomatic lacunar infarction. We performed carotid and intracranial MR angiography, and T2-weighted MRI on 65 patients with symptomatic lacunar infarction. Stenosis of more than 25% narrowing of the diameter was found in 12 patients (18.5%) in the extracranial carotid arteries and in 14 patients (21.5%) in the intracranial arteries. Most of the stenotic lesions were mild. Multiple logistic regression analysis showed that age was significant and independent predictor for carotid artery stenosis, and that diabetes mellitus was predictor for intracranial artery stenosis. The incidence of intracranial artery stenosis was statistically higher in patients with asymptomatic lacunar infarctions in subcortical white matter area on T2-weighted MRI than in patients without such lesions. Coexistence of carotid artery stenosis should be suspected in aged patients with symptomatic lacunar infarction, and the possibility of intracranial artery stenosis should be considered in patients with diabetes mellitus or asymptomatic lacunar infarctions in subcortical white matter area.
本研究的目的是阐明有症状腔隙性脑梗死患者颈动脉和颅内动脉闭塞性病变的患病率及程度。我们对65例有症状腔隙性脑梗死患者进行了颈动脉和颅内磁共振血管造影以及T2加权磁共振成像。在颅外颈动脉中,12例患者(18.5%)发现直径狭窄超过25%,在颅内动脉中,14例患者(21.5%)发现直径狭窄超过25%。大多数狭窄病变为轻度。多因素逻辑回归分析显示,年龄是颈动脉狭窄的显著且独立预测因素,糖尿病是颅内动脉狭窄的预测因素。T2加权磁共振成像显示,在皮质下白质区域有无症状腔隙性脑梗死的患者中,颅内动脉狭窄的发生率在统计学上高于无此类病变的患者。对于有症状腔隙性脑梗死的老年患者,应怀疑并存颈动脉狭窄,对于糖尿病患者或皮质下白质区域有无症状腔隙性脑梗死的患者,应考虑颅内动脉狭窄的可能性。