CT阴性脑梗塞的脑电地形图

本组16例脑CT均阴性且经MRI证实为脑梗塞。本组资料提示,在梗塞开始后的24小时内,BEAM异常率很高,但随着梗塞时间的延长,CT诊断的阳性率不断提高而BEAM阳性率逐渐下降。本组资料证实:α活动与脑血流量呈正相关而脑血流量与δ、θ活动呈负相关。对于脑深部和脑干部位的梗塞和腔隙梗塞,BEAM诊断的阳性率和定位价值均不高,但对于颈内动脉供血区的早期梗塞,即使梗塞面积较小,但只要位于脑浅表部位,BEAM仍有较高的定位价值。     

痴呆病人的神经心理、脑电活动与CT／MRI影像变化的对比研究

本文应用神经心理测查、脑电活动与ＣＴ／ＭＲＩ影像变化对比研究１３例Ａｌｚｈｅｉｍｅｒ痴呆和１２例多发性梗塞性痴呆病人之间的差异，发现Ａｉｚｈｅｉｍｅｒ痴呆的神经心理障碍较全面，多发性梗塞性痴呆为非全面性障碍。在脑电地形图上二者的θ频段两半球的对称系数不同、两组痴呆在ＣＴ／ＭＲＩ影像变化显示两半球脑萎缩的对称性有差异，并对其差异的产生机制及相互关系作了初步探讨。以上的变化可以为临床提供鉴别诊断的依据。     

多发性梗死性痴呆的脑电图分析

本文对 6 0例多发性梗死性痴呆患者脑CT与脑电图结果进行对比分析 ,现报告如下。1　临床资料1 1　病例选择选择 2 0 0 0年 8月至 2 0 0 2年 8月在我院神经内科住院的患者 6 0例 ,其中男 36例 ,女 2 4例 ,年龄 5 0～ 78岁 ,平均6 3岁。所有病例均符合全国第五届脑血管病学术会议制定的诊断标准 ,且均经CT证实为多发性脑梗死 ,并采用《精神病的诊断和统计手册 (DSM -IV)》中老年性痴呆的诊断标准诊断为痴呆[1] ,排除严重的听力和视力障碍者。1 2　脑CT检查全部病例均在发病 2 4h内和第 1周行 2次CT检查。首次脑CT检查出现梗死灶者 4 2例…     

小儿颅外伤性脑梗死的CT观察探讨

目的探讨小儿外伤性颅外伤性脑梗死的CT诊断价值。方法回顾性分析23例小儿颅脑外伤性性脑梗死的CT表现及临床资料。结果本组患儿梗塞灶21例位于基底节区，2例位于小脑。伤后3～50d复查，有5例病灶呈软化灶状态，18例消失。结论本病多发于婴幼儿，梗塞部位多位于基底节区。CT检查及复查不仅可以发现梗塞灶，而且还可观察其发展过程。     

多发性脑梗塞智能障碍临床观察

多发性脑梗塞智能障碍临床观察焦帼范，马琳，刘晓丹西安医科大学附属第二医院关键词多发性脑梗塞，ＨＤＳ量表，ＣＴ，痴呆我科收集６年来收治的脑血管病中诊断为ＭＩ的患者６４例，其中１１例发展为多发性梗塞性痴呆（ＭＩＤ），就其临床特点、ＣＴ表现、转归及与痴呆关...     

多发性脑梗塞性痴呆相关因素的研究

多发性梗塞性痴呆（ＭＩＤ）是老年期痴呆的主要类型之一。多数研究说明多发梗塞灶容积大小及梗塞灶的部位等是引起痴呆的主要原因，而且梗塞灶的容积大小与智能障碍的程度成正比［１－３］。老年脑多有不同程度的脑萎缩，关于脑萎缩与ＭＩＤ的关系研究不多。本研究采用病...     

脑内海绵状血管瘤的CT和MRI诊断

目的探讨脑实质内海绵状血管瘤（CA）的CT、MRI表现及其诊断价值。方法回顾性分析经手术病理证实的CA12例,8例行CT平扫,4例行CT增强扫描,12例均行MR检查,5例行Gd-DTPA增强扫描。结果12例CA共检出14个病灶。CA可发生于脑内任何部位,单发多见（10/12）。海绵状血管瘤CT平扫表现为类圆形高或稍高密度病灶,多数为不均匀,常伴钙化、出血。MRI平扫大部分表现为T1WI呈等信号或稍高信号,T2WI呈高、低混杂信号,11个病灶周围可见低信号环影,大多数病灶周围无水肿带及占位效应。CT和MRI增强后均呈轻度强化或无明显强化。结论CT和MRI检查对CA具有重要的诊断价值,MRI优于CT,是诊断本疾病最佳的影像学方法。     

腔隙性脑梗塞5O例临床治疗体会

目的探讨腔隙性脑梗死的临床特点．方法回顾性分析50例腔隙性脑梗塞患者的临床资料。结果本组50例患者中高血压病41例（82％），高脂血症17例（34％），高粘血症20例（40％），糖尿病12例（24％）常见临床类型为单纯运动性偏瘫22例，单纯感觉性卒中10例，无症状腔隙性梗塞6例，共济失调性卒中5例，腔隙状态5例，CT漏诊2例，后经MRI检查确诊病灶部位主要在基底节区22例，内囊6例，丘脑区4例。结论高血压是腔隙性脑梗死的直接原因，腔隙病灶主要位于基底节；腔隙状态的预后差，MRI对脑干、小脑及〈5mm或发病24h内的病灶优于CT。     

多发梗塞性痴呆与多发性脑梗塞脑电地形图的对比研究

本文对29名多发梗塞性痴呆,31名多发性脑梗塞患者及30名正常老年人的脑电地形图做了对比研究,发现多发梗塞性痴呆患者的慢波功率弥漫性增强,目双测不对称;多发性脑梗塞组部分区域的慢波功率增强;两组的 alpha 功率与正常组无差别;两组的 beta 功率较正常组在大部分区域下降。     

事件相关电位(P300)在多发梗塞性痴呆早期诊断中的研究

目的:探讨听觉事件相关电位P_(300)在多发梗塞性痴呆的早期诊断中的意义。方法:分别对24名无痴呆的多发性脑梗塞患者及年龄匹配的24名正常人进行神经心理学量表(长谷川智力量表)(HDS)评分及听觉P_(300)检测。结果:两组神经心理学量表(HDS)评分均正常。二组听觉P_(300)比较,无痴呆多发性脑梗塞组P_(300)潜伏期延长,有明显性差异。结论:听觉P_(300)潜伏期可能较HDS评分更为敏感,以及在多发梗塞性痴呆的早期诊断中具有重要意义。     

A voxel-based morphometric analysis of cerebral gray matter in subcortical ischemic vascular dementia patients and normal aged controls

BACKGROUND AND PURPOSE: The present study was designed to detect the abnormalities of the cerebral grey-matter density in subcortical ischemic vascular dementia patients by FSL-VBM method to promote the early diagnosis of it.METHODS: Nine subcortical ischemic vascular dementia patients and nine age-matched normal controls underwent MRI brain structure scanning that was performed on a SIEMENS AVANTO 1.5 Tesla scanner and standard T1-weighted high-resolution anatomic scans of MPRAGE sequence were obtained. The 3-demensional MPRAGE images were processed with FSL-VBM package and the cerebral gray matter density was compared between the subcortical ischemic vascular dementia patients and normal controls.RESULTS: Compared with the normal control group, the cerebral gray matter density of subcortical ischemic vascular dementia patients was found significantly decreasing, including brain regions of thalamus, parietal lobe, frontal lobe and temporal lobe (P<0.05).CONCLUSIONS: The cerebral gray matter density alterations have closed correlation with cognitive dysfunction in subcortical ischemic vascular dementia patient and can be detected by MRI. MRI has some potential value in the diagnosis of them.     

New onset seizures in the elderly: aetiology and prognosis

Late onset epilepsy is increasing in incidence. These patients often have significant underlying morbidity. This retrospective study in a tertiary referral centre identified 68 patients aged 65 years or older, with new onset seizures over a four-year period. 81% of patients (n = 55) were followed up at an average of 2.7 years post diagnosis. 38% of patients had evidence of cerebrovascular disease (CT visualised focal infarction, haemorrhage or small vessel ischaemia in 32%, clinical diagnosis with normal CT brain in 6%). No patient was found to have a space-occupying lesion. Of the 55 patients followed up, 45% of these had died at a mean age of 82 years old and 1.9 years post diagnosis (range 12 hours to 5 years). Three patients died as a direct result of seizures (trauma and sepsis). 14 patients died of clearly unrelated causes. Eight patients died from underlying vascular disease or Alzheimer's dementia. Patients who died during follow-up were on average 3.4 years older at the time of diagnosis than survivors (p< 0.05). Patients with atrial fibrillation at the time of diagnosis, had increased mortality (relative risk 2.53; 95% C.I. 1.19 - 5.36), but they were older than those without atrial fibrillation. At the time of follow up, 92% of those taking anti-convulsants were maintained seizure free on anticonvulsant monotherapy.     

CONTRAST STUDY ON CT AND BA IN DIAGNOSIS OF PATIENTS WITH ATHEROTHROMBOTIC BRAIN INFARCTION

~~CONTRAST STUDY ON CT AND BA IN DIAGNOSIS OF PATIENTS WITH ATHEROTHROMBOTIC BRAIN INFARCTION$河北省人民医院     

枕叶梗塞的临床、CT与视觉诱发电位分析

本文对28例枕叶梗塞病人分别进行了头颅CT及视觉诱发电位检查,结合临床分析,结果表明,枕叶梗塞临床少见,容易误诊,需要头颅CT或诱发电位检查协助诊断,且电生理阳性率优于形态学改变,可以弥补CT检查手段的不足。     

血管性痴呆患者事件相关电位P300及相关因素研究

目的：研究血管性痴呆患者的事件相关电位P300及相关因素诊断的应用。方法：对42例VD和36例无痴呆脑梗死患者进行听觉P300检测，并进行病因、病变部位等危险因素对比分析。结果：VD组常有高血压、糖尿病、震颤麻痹、皮质下病灶、双侧半球病灶及脑萎缩，并有2次以上座中发生。VD组N1、P2、N2、和P3潜伏期均明显延长，P2、P3波幅分别降低，与对照组比较差异有显著意义（P＜0．01）。结论：高血压、糖尿病、震颤麻痹，反复卒中、皮质病灶、多发性病灶、脑萎缩均是VD的危险因素，与VD的发生、发展有关。事件相关电位P300是一种客观的神经生理学指标，对VD的早期诊断有实用价值。     

血浆同型半胱氨酸水平及MTHFR基因多态性与血管性痴呆的关系

目的探讨血浆同型半胱氨酸(Hcy)水平及MTHFR基因多态性与血管性痴呆(VD)的关系。方法采用高效液相色谱分析法检测法测定68例VD及34例非痴呆脑梗死患者的血浆总同型半胱氨酸水平,运用多聚酶链反应-限制性内切酶片段长度多态性技术(PCR-RFLP)检测MTHFR基因多态性。结果VD脑梗死患者的平均血浆总同型半胱氨酸水平为18.54±9.21,VD患者的血浆总同型半胱氨酸水平显著高于非痴呆脑梗死组(P<0.01);MTHFR基因型有3种,即纯合子(T/T)型,杂合子(T/C)型,纯合子(C/C)型。3组基因型和等位基因频率相比,差异均无统计学意义(P>0.05)。结论高同型半胱氨酸血症可能是血管性痴呆(VD)独立危险因素之一。     

Increased neural progenitors in vascular dementia

Since groundbreaking studies demonstrated the presence of progenitor cells in the adult human brain, there have been intense interests in their potential therapeutic application, but to date only limited data has been obtained in man. An immunohistological study was performed in order to examine neurogenesis in both the subventricular and peri-infarct zones of vascular dementia patients compared to age-matched controls.The results were striking, showing a significant increase of progenitor cells in both the subventricular zone and in peri-infarct area in patients with vascular dementia compared to controls, which was sustained even in patients with infarcts occurring more than three months prior to autopsy. Moreover, the peri-infarct response appeared to be unified with that of the subventricular zone via a stream of cells, with some of them differentiating into immature neurons. We conclude that neurogenesis is stimulated in vascular dementia patients and, specifically, in patients with visible infarcts. Progenitors may migrate from the neurogenic niche to areas of infarction and differentiate into neurons, even three months after cerebrovascular damage, thus implicating the feasibility of enhancing neurogenesis as a novel treatment approach.     

儿童与成人支原体肺炎CT表现及临床意义

目的：分析儿童与成人支原体肺炎的CT影像表现特点,指导临床对支原体肺炎的早期诊断。方法：回顾性分析36例经血清学证实的支原体肺炎患者的CT影像资料,根据支原体肺炎患者的年龄分为儿童组（20例）和成人组（16例）,对其CT影像表现进行对比分析。结果：儿童组的病变部位主要位于右肺下叶11例（55％）、右肺中叶6例（30％）和左肺上叶5例（25％）,成人组的病变部位主要位于右肺下叶8例（50％）、左肺下叶5例（31％）和右肺中叶4例（25％）,两组间病变位于左肺舌叶、左肺下叶的发生率差异有统计学意义（P〈0．05）。入院时,儿童组的CT影像表现以大片状实变影为主15例（75％）,成人组CT影像表现以磨玻璃样变12例（75％）和小斑片状实变影8例（50％）为主,两组间CT影像表现差异有统计学意义（P〈0．05）。结论：儿童与成人支原体肺炎的病变部位和CT影像表现具有一定的特征性,对支原体肺炎的早期诊断有重要的指导意义。     

血管性痴呆42例脑电图分析

目的：探讨血管性痴呆患的脑电图特点。方法：对42例1989年9月至2001年4月我院住院患进行脑电图描记。结果：①90％的患脑电图出现θ、δ波。②脑电图异常与痴呆程度呈正相关系。③多灶性梗塞所致痴呆患的脑电图大多呈弥漫性改变,单灶性梗塞所致痴呆以局限性改变为主。结论：脑电图可评定血管性痴呆患的脑功能损害程度和梗塞部位。     

脑囊虫病脑电图与CT的对比分析

目的：对脑囊虫病患者的ＥＥＧ及头颅ＣＴ资料进行对比分析,以探讨其临床意义。方法：对５８例脑囊虫病患者进行常规ＥＥＧ及头颅ＣＴ检查。结果：ＥＥＧ异常率为７２％,主要表现为额、中央及前颞区弥漫性不规则复型慢波。ＣＴ的异常率为５０％,多表现为散在的点、片状高或低密度灶。二者比较差异有显著性。结论：脑囊虫病患者ＥＥＧ异常率显著高于ＣＴ,临床上二者结合有利于该病的早期诊断及治疗