胼胝体梗死14例分析

目的探讨胼胝体梗死的病因及临床表现。方法回顾性分析14例经头颅MRI扫描证实的胼胝体梗死的临床和影响像学资料。结果胼胝体梗死临床表现复杂,且很少单一发生,多合并其他部位脑梗死。结论胼胝体梗死应及早诊断,及时治疗,预后多较好。     

胼胝体梗死的临床与磁共振影像特点

目的探讨胼胝体梗死患者的临床和磁共振检查的影像学特点。方法回顾22例急性胼胝体梗死患者的临床和磁共振检查资料,分析其主要临床特点及其特征性影像学表现。结果胼胝体梗死主要表现为肢体瘫痪、认知功能下降、语言障碍、情感障碍、面舌瘫痪、感觉障碍、偏侧肢体失用。磁共振影像显示,胼胝体体部和膝部梗死患者的大脑前动脉狭窄或闭塞率明显高于胼胝体压部梗死患者（χ2分别为4.996、4.337,P均〈0.05）,胼胝体压部梗死患者的大脑后动脉狭窄或闭塞率明显高于胼胝体体部和膝部梗死患者（χ2分别为4.337、4.996,P均〈0.05）。结论胼胝体梗死临床表现复杂多样,颅脑磁共振检查是确诊胼胝体梗死的依据。     

胼胝体梗死的MRI特征(附78例报告)

目的 探讨胼胝体梗死的磁共振成像(MRI)特征.方法 回顾性分析78例胼胝体梗死患者的影像学及临床资料.结果 单纯胼胝体梗死少见(8/78),多合并颅内其他部位梗死灶.胼胝体梗死部位:膝部16例,体部7例,同时累及膝部、体部15例,压部34例,弥漫性累及6例.累及胼胝体的脑梗死临床表现以肢体瘫痪﹑语言障碍﹑智能与精神障碍较多见.结论 胼胝体梗死并不少见,其临床表现常被合并的梗死病灶所掩盖,MRI是确诊的主要依据.     

胼胝体梗死临床特点分析

目的探讨胼胝体梗死患者的临床表现、影像学表现以及预后。方法纳入胼胝体梗死患者11例,对其临床特征及头颅CT、MRI表现及预后等进行回顾性分析,总结胼胝体梗死的临床特点。结果胼胝体梗死患者中,梗死范围局限于胼胝体的局限病灶患者占27.3%,合并胼胝体外梗死的弥散性病灶患者占72.7%。胼胝体梗死患者临床可表现为失语、肌力减退、智能障碍、小便失禁、感觉障碍、意识障碍、共济失调、情感障碍等症状,病变除累及胼胝体外还多合并基底节区、额叶、顶叶、颞叶等部位梗死。随访1年,患者痊愈或症状改善为10例(90.9%),恶化1例(9.1%)。结论胼胝体梗死患者临床表现复杂多变,头颅MRI对胼胝体梗死的诊断具有重要价值,经积极治疗预后良好。     

胼胝体梗死14例临床分析

目的探讨胼胝体梗死的高危因素,临床表现及诊断分型。方法对14例胼胝体梗死患者的临床资料进行分析。结果胼胝体梗死高危因素主要为高血压病,糖尿病,最主要的临床表现为肢体瘫痪、失语及智能改变、感觉障碍,病变部位以体部及膝部多见。依据CISS标准分型提示胼胝体梗死为动脉粥样硬化性脑梗死。结论胼胝体梗死临床表现非特异性,临床诊断需要依靠MRI检查,病因多为动脉粥样硬化。     

老年胼胝体脑梗死40例临床特点分析

目的 总结胼胝体梗死的临床特点.方法 老年胼胝体脑梗死患者40例,对其一般情况、发病原因、临床表现、影像学特点及预后进行分析.结果 高危因素主要为动脉粥样硬化,病灶位置以胼胝体膝部、体部和压部多见;临床表现多样,其中运动障碍18/40(45.0％)、高级智能障碍15/40(37.5％)、感觉障碍9/40(22.5％)、言语障碍8/40(20.0％)、精神情绪障碍6/40(15.0％),伴异己手综合症2例、一过性小便失禁2例;治疗总有效率为90％.结论 胼胝体梗死高危因素以动脉粥样硬化为主,临床表现复杂,MRI是最佳诊断手段,早期发现、积极治疗者预后较好.     

胼胝体梗死的临床表现及影像学特点分析

目的探讨胼胝体梗死的临床表现及影像学特点。方法将2011年6月—2012年3月在开封市第二人民医院确诊的12例胼胝体梗死患者的临床表现及影像学资料进行分析。结果 (1)单纯病灶组与合并其他部位病灶组患者梗死灶左右发生率比较,差异无统计学意义(P>0.05);两组患者胼胝体膝部梗死发生率与其他部位梗死发生率比较,差异无统计学意义(P>0.05)。(2)临床表现以肢体瘫痪者最多(占75.0%),多由胼胝体膝部梗死引起;其次是语言障碍(占33.3%),左手失用、眩晕、精神行为异常、中枢性面舌瘫者较为少见。(3)单纯梗死组者以轻度瘫痪为主(占57.1%),下肢受累多见;而合并其他部位梗死组多瘫痪程度较重(占60.0%),且以上下肢同时受累多见。结论本研究12例胼胝体梗死患者中病灶左右发生率及好发部位无显著性差异,其临床表现与部位及是否合并其他部位梗死有关。     

胼胝体梗死:临床与影像学特征

目的 探讨胼胝体梗死患者的临床和影像学特征.方法 回顾性收集经颅脑MRI证实的胼胝体梗死患者,对其临床表现和影像学资料进行分析.结果 胼胝体梗死占所有脑梗死患者的1.04％(7/671),其主要危险因素是高血压、冠心病和糖尿病.典型表现包括观念运动性失用(42.9％)、额叶步态(28.6％)和异己手综合征(14.3％),可伴有肢体瘫痪、意识障碍和认知损害等症状.MRI共检出胼胝体病灶8个,以体部多见(62.5％),其次为压部(25.0％)和膝部(1/8,12.5％).额叶(57.1％)、基底节区(42.9％)和枕叶(42.9％)常同时被累及.弥散张量成像显示,l例患者胼胝体体部和膝部纤维连接中断.6例患者血管造影显示血管狭窄或闭塞,其中以椎动脉狭窄最多见(66.7％),其次为大脑前动脉(50.0％),颈总动脉、颈内动脉和大脑中动脉较少见(均为33.3％).结论 胼胝体梗死发生率低,动脉粥样硬化是致病关键,其临床表现多样,与梗死部位有关.     

胼胝体梗死患者8例临床分析

胼胝体是连接两侧大脑半球的连接纤维,是脑内最大的纤维束.此纤维束的主要功能是执行两大脑半球间的协同活动、视觉功能和信息传导功能.单纯胼胝体病变在临床上相对少见. 国内外文献尚没有系统和全面的胼胝体梗死特征的临床表现的描述.本文对8例老年胼胝体梗死患者进行临床分析,并作文献复习.     

急性胼胝体梗死33例临床及影像学分析

目的探讨急性胼胝体梗死的临床及影像学特征：方法回顾性分析2006年4月-2010年4月安徽医科大学附属省立医院1609例脑梗死患者中,经MRI确诊的33例胼胝体梗死患者的临床及影像学资料结果①该病发生率为2．05％（33／1609）;发病年龄为（63±9）岁,主要危险因素是高血压、高脂血症和糖尿病。②33例中,以肢体瘫痪（93．9％）和认知功能下降（57．6％）最为多见,其次是面、舌瘫（48．5％）,共济失调（45．5％）,感觉障碍（39．4％）,再次是情感障碍和语言障碍（均为30.3％）,而异己手综合征最少见（9．1％）。（3）33例通过MRI检出病灶42个,以体部（42．9％）、压部（35．7％）多见。6例为单纯胼胝体梗死,27例合并颅内其他部位梗死,最多见于基底核区（75．8％）。单侧梗死患者（24／33）多于双侧（9／33）,P〈0．01。④15例行血管造影检查（MRA／CTA／DSA）,大腩的动脉狭窄6例,闭塞3例;胼周动脉狭窄3例,闭塞2例;大脑中动脉狭窄1例,大脑后动脉狭窄3例,闭塞2例;血管形态正常者2例。结论胼胝体梗死发生率相对低,临床表观复杂多样,应重视认知功能的下降和异己手综合征,MRI对胼胝体梗死定位诊断具有重要意义。     

胼胝体梗死的临床与影像学分析

目的 探讨胼胝体梗死患者的临床和影像学特点.方法 收集符合脑梗死诊断的416例患者的临床资料,其中8例经过MRI证实为胼胝体梗死.结果 胼胝体梗死占全部脑梗死患者的1.9%.7例CT扫描未显示胼胝体梗死,经非增强MRI检查显示病灶,另1例经增强MRI检查显示病灶.梗死灶可仅累及胼胝体(膝部、体部或压部),也可合并额叶、...     

急性单纯胼胝体梗死的临床诊治分析并文献复习

目的 探讨急性单纯胼胝体梗死的临床特点.方法 连续回顾性分析2010年1月至2018年12月首都医科大学附属复兴医院2694例脑梗死患者中,经MRI确诊的16例急性单纯胼胝体梗死患者临床资料,包括患者性别、年龄、卒中危险因素、影像学特征等,并记录患者胼胝体梗死的部位、胼胝体供血动脉有无狭窄以及颅内外狭窄血管的数量等,评价治疗前与出院时美国国立卫生研究院卒中量表(NIHSS)评分的变化.出院后6个月完成门诊病情评估.16例急性单纯胼胝体梗死患者中,男10例,女6例;年龄46~82岁,平均(69.4±2.3)岁;高血压病14例,2型糖尿病12例,高脂血症11例,冠心病5例(含心房颤动1例),高同型半胱氨酸血症4例,脑梗死6例,脑出血1例;吸烟史8例,饮酒史4例.结果 急性单纯胼胝体梗死占同期脑梗死的发生率为0.6%(16/2694),均伴有多个动脉粥样硬化危险因素,最主要危险因素是高血压病.16例急性单纯胼胝体梗死患者中,病变血管以大脑前动脉狭窄(14例)、大脑中动脉狭窄(10例)和颈内动脉狭窄(8例)多见;病变部位以胼胝体膝部和体部多见(12例),且以单侧受损为主(累及单侧胼胝体15例);临床以肢体瘫痪(13例)、认知障碍(10例)和精神行为异常(8例)为主要表现,偏身感觉异常(2例)、偏盲(1例)及共济失调(3例)较少见;经治疗后多数患者的病情可明显改善.治疗前NIHSS评分为(4.3±1.5)分,出院时NIHSS评分为(2.9±1.2)分,治疗前后的差异有统计学意义(t=3.914,P=0.023).出院6个月门诊随访结果显示,2例基本痊愈,13例显著进步,1例无变化,无死亡患者.结论 急性单纯胼胝体梗死发生率较低,其发病与颅内多支动脉狭窄密切相关,前循环血管可能更易受累.临床症状复杂多样,尤其应关注患者肢体肌力、认知功能及精神行为表现,一般预后良好.     

Abnormalities of the Corpus Callosum in Children Prenatally Exposed to Alcohol

For 20 years, it has been known that fetal alcohol syndrome (FAS) is associated with abnormal brain development. Early autopsy studies point to the corpus callosum as one area affected by heavy alcohol exposure. Little is known, however, about the integrity of the brain in alcohol-exposed children who survive the perinatal period. This study was designed to assess the corpus callosum in living children exposed to high doses of alcohol prenatally. Thirteen children with histories of significant prenatal alcohol exposure and 12 normal control children were evaluated using magnetic resonance imaging. Using the midsagittal section, images were measured for the area of the corpus callosum using a computer-assisted measurement technique. In addition to the overall area, five equiangular regions were determined for each corpus callosum. Of the 13 alcohol-exposed children assessed, two had agenesis of the corpus callosum. The remaining alcohol-exposed children had significantly smaller overall callosal areas, as well as smaller regional areas of four of the five callosal regions, when compared with the normal control children. Importantly, when corrected for brain size, three of the five callosal regions were still smaller in the alcohol-exposed children, although overall area of the corpus callosum was no longer significantly different. These results suggest that prenatal exposure to high levels of alcohol is associated with abnormalities of the corpus callosum. They verify callosal agenesis in children with FAS, which previously had only been noted in autopsy reports. The current findings further document selective reductions in the area of certain regions of the corpus callosum after in utero alcohol exposure, extending our current understanding of alcohol's teratogenic effects on brain development. There is also some indication that the selective reduction in the area of the corpus callosum is similar to that reported in attention deficit disorder.     

Interhemispheric transfer in children with heavy prenatal alcohol exposure

BACKGROUND: Prenatal alcohol exposure has long been associated with alterations in brain structure and behavioral changes. The corpus callosum can be affected by heavy prenatal alcohol exposure, and agenesis (absence) of this structure occurs more often in children with fetal alcohol syndrome than in the general population or in other developmentally delayed populations. Although the majority of children with fetal alcohol syndrome do not have agenesis of the corpus callosum, callosal area is reduced in this population, particularly in the anterior and posterior regions. However, the functional implication of these size reductions has not been examined. METHODS: The current study used a finger localization task to measure the transfer of information across the corpus callosum in children and adolescents with histories of heavy prenatal alcohol exposure and age- and sex-matched controls. In a subset of children, correlational analysis was also conducted between behavioral data and cross-sectional area of the corpus callosum. RESULTS: When compared with nonexposed controls, alcohol-exposed children made more errors on trials for which information had to cross the corpus callosum ("crossed" trials) than on trials for which it did not ("uncrossed" trials), and they also made more errors as the task increased in complexity. Additionally, correlations with magnetic resonance imaging data in a subset of children revealed that impairment in interhemispheric transfer was related to reductions in the size of the corpus callosum. These correlations were independent of effects expected from the relationship between corpus callosum size and general intellectual functioning alone. CONCLUSIONS: These findings suggest that children with heavy prenatal alcohol exposure display subtle deficits in the interhemispheric transfer of information in the somatosensory domain. Such deficits in interhemispheric transfer are likely to be related to the myriad of other behavioral and cognitive impairments observed in these children.     

Corpus Callosal Thickness in Alcoholics

The coronal thickness of the corpus callosum in alcoholics and age- and sex-matched controls was measured in a postmortem study. The alcoholics were found to have a significantly (p <0.001) reduced corpus callosal thickness (3.19 mm) when compared to the controls (4.02 mm). This adds weight to the previous pathological finding of reduced white matter volume in alcoholics, which presumably correlates with brain shrinkage seen on CT scans. A significant linear relationship exists between age and the corpus callosal thickness in controls and the white matter volume and corpus callosal thickness in alcoholics.     

Extensive callosal infarction showing difficulty in knitting as an initial symptom

A 66-year-old right-handed woman with type 2 diabetes mellitus was admitted to our hospital with progressive dysarthria and gait disturbance preceded by difficulty in knitting. Brain magnetic resonance imaging (MRI) showed a lesion involving the entire corpus callosum. Although tumor was considered in the differential diagnosis because of the atypical imaging findings, she was diagnosed with infarction based on clinical improvement after admission and sequential changes in MRI. We suggest that difficulty in knitting may be an important early manifestation of a callosal disconnection syndrome and that follow-up clinical and imaging examinations would contribute to confirmation of the diagnosis.     

胼胝体区脑胶质瘤34例MRI诊断及手术病理对照研究

目的　探讨胼胝体区胶质瘤的MRI表现 ,提高对该类肿瘤的诊断和鉴别诊断能力。方法　对 34例胼胝体区胶质瘤行MR平扫及增强扫描 ,并与手术及病理结果做对照分析。结果　胼胝体胶质瘤表现为胼胝体长T1长T2 异常信号 ,信号强度均匀或不均匀 ,有明显占位效应 ,注射Gd DTPA后增强扫描 ,根据肿瘤病理类型的不同可出现明显强化、轻度强化或不强化。胼胝体区肿瘤侵及双侧或单侧脑叶时 ,可出现“蝴蝶征”或“半蝴蝶征” ,此二种征象是诊断胼胝体区胶质瘤的重要征象。结论　胼胝体区胶质瘤是颅内特殊部位的肿瘤 ,MRI对该类肿瘤的诊断和鉴别诊断具有重要临床价值