后循环梗死的临床表现分析

目的 了解后循环梗死常见临床症状、体征及特征性表现.方法 回顾性分析2004-2006年在我院神经内科住院的急性后循环梗死且资料完整的216例资料.所有患者在入院时均接受头颅MRI检查,证实在后循环供血区存在责任病灶.总结患者的临床症状和体征,分析后循环临床表现的特征及与病灶部位的关系.结果 患者常见的症状为偏侧肢体无力(81.9%)、口齿含糊(46.3%)、头晕(33.8%)、偏侧麻木(31.0%);最常见的体征足偏侧运动障碍(81.9%)、中枢性面舌瘫(61.1%)、构音障碍(46.3%)、偏侧感觉障碍(31.0%)及共济失调(30.1%);交叉性瘫痪发生率低(2.8%),单独的眩晕极少(1.4%);延髓麻痹、意识障碍、视力障碍及记忆障碍等症状有助于定位;经典的脑干综合征具有定位意义.结论 后循环梗夕匕临床表现复杂多变,特征性临床表现和临床综合征有助于后循环梗死的诊断.

The clinical characteristics of patients with posterior circulation ischemic stroke

objective To describe the clinical features of patients with posterior circulation ischemic stroke.Methods 216 patients with posterior circulation ischemic stroke admitted in our department during 2004-2006 were analyzed retrospectively.All patients were undertaken MRI on admission and responsble lesions were identified at the posterior circulation territories.The patients'clinical symptoms and signs were evaluated and the relationships between lesion locations and clinical characteristics were analyzed.Results The common symptoms of posterior circulation ischemic stroke were unilateral limb Weakness(81.9%),speech difficulty(46.3%),dizziness(33.8%),and unilateral limb numbness (31.O%).The common signs of posterior circulation ischemic stroke were unilateral limb weakness (81.9%),central facial or lingual palsy(61.1%),dysarthria(46.3%),unilateral limb sensory loss (31.0%),and ataxia(30.1%).The incidence of crossed paralysis was low(2.8%).Isolated vertigo was rare (1.4%).Predominant clinical features such as bulbar paralysis,unconsciousness,visual disorder and amnesia can help to localize the lesions.Typical brainstem syndromes had topographic meanings.Conclusions The clinical features of patients with posterior circulation ischemic stroke were complex.Predominant symptoms can help to diagnose the posterior circulation ischemic stroke.