基底动脉尖综合征20例临床分析

目的 探讨基底动脉尖综合征（TOB）的临床及影像学特征。方法 对20例TOB综合征患者临床及影像学资料进行分析。结果 意识障碍、瞳孔及眼球运动异常、偏盲及皮质盲、偏瘫或四肢无力是最常见的症状及体征，影像学改变以丘脑、脑干、枕叶为主．头颅CT特征性改变为双侧丘脑、中脑或桥脑部中央及旁中央区低密度；MRI为T1低信号、T2高信号改变，MRI对该病诊断更敏感，能早期发现并可及时跟踪病情变化；脑血管造影（DSA）可明确血管狭窄部位。术中溶栓治疗效果好。结论 TOB综合征同时有幕上和幕下多处梗塞，主要病因为栓塞和血栓形成，临床治疗困难，预后差。早期发现，及时溶栓治疗有一定临床意义。

A analysis of clinic aboat Top of the basilar syndrome:20 cases report

Objective To analyze the clinical and image findings of TOB syndrome,for strengtehing recognition and early diagnosis. Methods Clinical, head CT and MRI daras of 20 cases TOB sysdrome were retorspectivcly analysed. Resulls Demonstrated unconsciousness. Pupillo oculom otorabnormality, hemianopsia or asimutagnasia. Hemipares or erbilateral paresis were the most frequent, characteristics of this syndronm. The thalamic infarctions were the most frequent, midbrain or pons infroctions secondary. Bilareral Thalamas battorly hypodensity fodlowy by midbrain or poas cenferparamedian area hypodensisty were the CT-scaniy charaecerizations; MRI was a low signal on Tiw image and a high signal on TZW image. MRI was superior to CT in detecting these lesions. DSA definitude in the detection intracranial stenosis vessels. Intra-arterial thombolysis was an effective therapy to TOB. Conclusions TOB syndrome covers the supra and infratentorial imultiple inforctions heal worse prognosis. As early as possisble clinial suspected cases are performed MRI ,DSA for early diagnosis intra-arterial thombolysis is an effective therapy to TOB.