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1.
周旭东  张力明  方宁静 《中国现代医生》2013,(14):101-103,F0003
目的探讨脑桥梗死部位与基底动脉狭窄、弯曲的关系。方法回顾性发析2009年1月~2012年10月在本院神经科住院治疗新鲜脑桥梗死患者118例及前循环脑梗死105例(所有病例有头颅MRI及颅内外动脉CT血管成像(CTA)检查)。将脑桥梗死组设为A组:梗死位于脑桥中线一侧;B组:梗死部位位于脑桥中线两侧。脑桥梗死两组与基底动脉狭窄、弯曲作相关性统计分析。同时比较脑桥梗死组与前循环脑梗死组的基底动脉狭窄、弯曲发生率。结果118例脑桥梗死中A组78例:基底动脉狭窄6例(7.69%),基底动脉2级弯曲60例(76.92%);B组40例:基底动脉狭窄或闭塞40例(100%),基底动脉2级弯曲32例(80%)。105例前循环脑梗死组中基底动脉狭窄5例(4.76%);基底动脉2级以上弯曲15例(14.29%)。①脑桥梗死A、B两组基底动脉狭窄或闭塞发生率有显著性差异(χ^2=94.72,P=0.00)。脑桥梗死A、B两组基底动脉弯曲度无明显差异(χ^2=0.146,P=0.703)。(参脑桥梗死组与前循环梗死组的基底动脉狭窄、弯曲比较有明显差异(χ^2=38.27、90.27,P=0.00、0.00)。结论脑桥梗死部位与基底动脉狭窄或闭塞、弯曲有关。  相似文献   
2.
目的 探讨急性孤立性脑桥梗死病灶模式与病因学机制的相关性.方法 回顾性收集急性孤立性脑桥梗死患者的临床资料,应用弥散加权成像(diffusion-weighted imaging,DWI)确定病灶分布模式,分析病灶模式与病因学分型之间的相关性.结果 总共纳入146例急性孤立性脑桥梗死患者,单侧梗死138例,双侧梗死8例.DWI病灶模式分析显示,旁正中梗死98例,前外侧梗死11例,被盖部梗死18例,多发性梗死19例;在各病因学分型中,基底动脉分支病变(basilar artery branch disease,BABD)所占比例最高(72例,49.3%),其次是大动脉闭塞性疾病(32例,21.9%)、小动脉闭塞性疾病(25例,17.1%)和其他病因/病因不明(12例,8.2%),心源性栓塞最少(5例,3.4%).急性孤立性脑桥梗死的DWI病灶分布模式与病因学分型存在显著相关性(C=0.516,P<0.001).其中,60例旁正中梗死(χ2=16.915,P<0.001)、1例前外侧梗死(χ2=7.701,P=0.006)、1例被盖部梗死(χ2=17.401,P<0.001)与BABD显著相关;9例旁正中梗死(χ2=12.534,P<0.001)、6例前外侧梗死(χ2=24.365,P<0.001)、10例被盖部梗死(χ2=18.312,P<0.001)与小动脉闭塞性疾病有关.结论 急性孤立性脑桥梗死病灶模式与其病因学机制存在显著相关性,早期可通过DWI显示的梗死灶分布特征来预测急性孤立性脑桥梗死的病因.  相似文献   
3.

Background and purpose

The salt-and-pepper pain is a characteristic sensory disturbance confined to the eyes and regional facial structures. Although a poor prognosis has been mentioned in previously reported patients, the precise pathomechanism and clinical significance are still unknown.

Patients and methods

We report four patients with ocular salt-and-pepper pain, and review the clinical course, neuroimaging and prognosis in another eight patients reported in the literature.

Results

In our series, they were three men and one woman, and their underlying cause was pontine hemorrhage; hypertensive hemorrhage in three and cavernous hemangioma in one patient, respectively. In these 12 salt-and-pepper patients, the identifiable etiology was exclusively brainstem stroke. Life-threatening or disable neurological deterioration ensued within 24 h after pain onset in all patients. Their ocular pain subsided rapidly after neurological deterioration occurred. A dual excitation of nociceptive quinothalamic pain fiber and disinhibition of trigeminosensory system from pontine reticular formation and cerulotrigeminospinal circuit may be responsible for this pain.

Conclusion

In clinical practice, ocular salt-and-pepper pain in quiet eyes should be alerted for intracranial pathology and neurological deterioration until underlying cause is identified.  相似文献   
4.
<正>患者女性,87岁。因头晕伴站立不稳3 d,于2014年3月31日入院。患者入院前3 d突发头晕伴站立不稳、行走不能,无头痛或视物旋转。外院急诊头部CT检查显示双侧基底节区、放射冠多发性腔隙,呈增龄性改变,临床诊断为腔隙性梗死。予以醒脑静注射液20 ml/d和丹红注射液20 ml/d静脉滴注,连续治疗3 d后病情无明显改善,遂以"头晕、行走不稳待查"收入我院神经内科。患者既往有明确  相似文献   
5.
The relationship between genes and behavior, and particularly the hyperactive behavior, is clearly not linear nor monotonic. To address this problem, a database of the locomotor behavior obtained from thousands of mutant mice has been previously retrieved from the literature. Data showed that the percent of genes in the genome related to locomotor hyperactivity is probably more than 1.56%. These genes do not belong to a single neurotransmitter system or biochemical pathway. Indeed, they are probably required for the correct development of a specific neuronal network necessary to decrease locomotor activity. The present paper analyzes the brain expression pattern of the genes whose deletion is accompanied by changes in locomotor behavior. Using literature data concerning knockout mice, 46 genes whose deletion was accompanied by increased locomotor behavior, 24 genes related to decreased locomotor behavior and 23 genes not involved in locomotor behavior (but important for other brain functions) have been identified.These three groups of genes belonged to overlapping neurotransmitter systems or cellular functions. Therefore, we postulated that a better predictor of the locomotor behavior resulting from gene deletion might be the brain expression pattern. To this aim we correlated the brain expression of the genes and the locomotor activity resulting from the deletion of the same genes, using two databases (Allen Brain Atlas and SymAtlas). The results showed that the deletion of genes with higher expression level in the brain had higher probability to be accompanied by increased behavioral activity. Moreover the genes that were accompanied by locomotor hyperactivity when deleted, were more expressed in the cerebral cortex, amygdala and hippocampus compared to the genes unrelated to locomotor activity. Therefore, the prediction of the behavioral effect of a gene should take into consideration its brain distribution. Moreover, data confirmed that genes highly expressed in the brain are more likely to induce hyperactivity when deleted. Finally, it is suggested that gene mutations linked to specific behavioral abnormalities (e.g. inattention) might probably be associated to hyperactivity if the same gene has elevated brain expression.  相似文献   
6.
目的:探讨大鼠单侧桥脑、中脑电损伤后脑干三叉神经诱发电位(BTEP)的变化规律。方法:对80只大鼠分别在左侧面丘深部或上下丘之间按照电流刺激量的不同给予电损伤,各分为小剂量组(1mA)、中剂量组(3mA)和高剂量组(61TIA),并设立对照组(0mA),共8组,每组10只,记录各组鼠在电损伤前后的BTEP波形,比较其间的变化。结果:BTEP在各剂量中中脑损伤组损伤前后均无变化,但桥脑损伤组中损伤后小剂量组的T1波的潜伏期(PL)延长;中、高剂量组的T1、T2、T3波的PL均延长。结论:刺激一侧BTEP能够反映同侧桥脑损伤,其T1波PL的延长可能是敏感指标,但不能反映同侧中脑损伤。  相似文献   
7.
目的 探讨脑桥梗死部位与椎基底动脉狭窄或闭塞之间的关系.方法 连续入选2005年2月至2007年9月收住北京宣武医院神经内科的新发脑桥部梗死患者139例,所有病例均行头部MRI以及全脑血管造影检查,排除有可疑心源性栓子来源的患者.将病例分为A(旁中央动脉组)、B(短旋动脉组)、C(长旋动脉组)、D(混合组)4组,并对各组进行与椎动脉、基底动脉狭窄或闭塞以及无血管病变的相关性研究.结果 139例患者中A、B、C、D组各占78(56.1%)、3(2.2%)、7(5.0%)、51(36.7%)例.左或右侧椎动脉闭塞者56例(40.3%),左或右椎动脉狭窄者60例(43.2%),基底动脉闭塞者14例(10.1%),基底动脉狭窄者14例(10.1%),无后循环血管改变者16例(11.5%).A组与椎动脉闭塞、基底动脉闭塞及无血管病变者相关,x2值分别为3.945、6.824、4.485,P值分别为0.043、0.021、O.041.D组与基底动脉闭塞相关,x2值为10.952,P值为0.006.对以上两者进行Logistic回归分析,发现A组与椎动脉闭塞更相关(OR值为2.261),D组与基底动脉闭塞更相关(OR值为15.750).结论 脑桥不同部位的梗死与椎基底动脉的狭窄或闭塞关系密切,提示临床医生在遇到相关病例时,应提高警惕,及时做血管检查.
Abstract:
Objective To investigate the correlation between stenosis or occlusion of vertebralbasilar artery and the location of infarctions in pontine. Methods All 139 patients with acute pontine infarction who were admitted to the Department of Neurology,Xuanwu Hospital,Beijing,during February,2005 and September,2007 were studied. All patients received the examinations of head MRI and digital subtraction angiography (DSA). Patients with possible cardiac embolism were excluded from the study. All the cases were then divided into four groups: A( paracentral artery group); B (short rotary artery group); C (long rotary artery group) and D (combined group). Results In all 139 cases,78 cases (56. 1% ) were in A group,3 (2. 2% ) in B group,7 (5.0%) in C group and 51 (36.7%) in D group. Fifty-six cases (40. 3% ) have occlusion in vertebral artery,60 cases (43.2%) have stenosis of vertebral artery. Cases having stenosis or occlusion in basilar artery are 14 cases (10. 1% ) each. Sixteen cases (11.5%) have unimpaired vertebral-basilar artery. A group is related to occlusion of vertebral artery and basilar artery and unimpaired artery ( x2 =3. 945,6. 824,4. 485 ,P = 0. 043,0. 021,0. 041 respectively). D group is related to occlusion of basilar artery ( x2 = 10. 952,P = 0. 006). Logistic binary analysis found that A group is more related with occlusion of vertebral artery ( OR = 2. 261 ),while D group is more related to occlusion of basilar artery ( OR = 15. 750). Conclusions There is a significant correlation between stenosis or occlusion of vertebral-basilar artery and the locations of infarctions in pontine. The physicians are suggested to perform the examinations on cerebral vessels such as brain MRI or DSA in patients with infarctions in pontine.  相似文献   
8.
Lasting taste disturbance has been previously reported as a consequence of brainstem infarction, but there are no previous reports of transient gustatory sensations preceding the onset of stroke. Ophthalmodynia, presenting as “salt-and-pepper” eye pain, has been reported rarely. We present a 58-year-old right-handed woman who had fluctuating ophthalmodynia and taste disturbance immediately preceding a left paramedian pontine infarction. We discuss the neuroanatomical basis of taste in reference to this presentation.  相似文献   
9.
目的 分析桥脑海绵状血管瘤的显微外科手术治疗方法 和预后.方法 显微手术切除桥脑海绵状血管瘤12例.11例位于桥脑背侧的海绵状血管瘤,采用枕下正中经菱形窝入路切除;1例位于桥脑腹外侧的海绵状血管瘤,采用颞下经小脑幕入路切除.结果 均镜下全切除病灶,术后病理证实为脑海绵状血管瘤.术后临床表现改善6例,无变化3例,面瘫加重1例,出现外展神经瘫痪1例,死亡1例.术后平均随访时间3个月,复查MRI均未见病灶复发,脑干组织影像学修复良好,术后遗留的临床症状均有不同程度的恢复.结论 在正确选择手术适应症及手术方法 的前提下,桥脑海绵状血管瘤的手术治疗是安全和有效的.  相似文献   
10.
磁共振脑径线测量对多系统萎缩的诊断价值   总被引:1,自引:0,他引:1  
目的 研究磁共振脑径线测量对于多系统萎缩(MSA)的诊断价值.方法 11例MSA患者,可能MSA 2例,拟诊MSA 9例.其中以帕金森综合征为主要表现(MSA-P)5例,以小脑性共济失调为主要表现(MSA-C)6例.健康对照组6名,病例对照组9例(帕金森病1例、其他类型的帕金森综合征8例).选取反映脑干、小脑和基底节形态学的径线进行测量,计算全脑三维体积,比较各项参数的组间差异.结果 MSA组的脑桥横径(mm,下同)明显短于健康对照组和病例对照组(27.6±2.0、30.5±0.6、29.9±1.1),MSA患者的四脑室前后径(11.9±2.8)明显长于健康对照(9.0±2.1).MSA-C组的脑桥横径明显短于健康对照组和病例对照组(27.2±2.1、30.5±0.6、29.9±1.1).MSA-C患者的四脑室前后径和横径(12.8±2.6和9.0±2.1)明显长于健康对照(17.3±2.1和13.8±1.7).MSA-P患者的脑桥横径较健康对照组短(28.2±1.8、30.5±0.6).MSA-P患者的苍白球最长径(23.7±5.0)和红核直径(6.6±0.8)明显较MSA-C患者(29.7±2.4和8.2±0.4)短.MSA-C患者的第四脑室横径较MSA-P患者宽(17.3±2.1、12.6±2.7),小脑中脚宽度较MSA-P患者缩短(13.3±1.9、15.8±1.2).结论 磁共振脑体积径线测量对于MSA患者脑组织局部萎缩的程度提供了量化的手段.脑桥的横径缩短可以客观地反映MSA患者脑桥的萎缩,但不能用于区分MSA-P和MSA-C.MSA-C患者更易出现第四脑室的扩大和MCP的萎缩,MSA-P患者更易出现红核萎缩.  相似文献   
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