成人型烟雾病的临床特征与经颅多普勒超声分析

目的研究成人型烟雾病的临床特点及经颅多普勒超声(TCD)检测对诊断烟雾病的临床价值。方法归纳64例经磁共振血管成像(MRA)或数字减影血管造影(DSA)确诊的年龄≥14岁的成人型烟雾病患者的临床特征及经颅多普勒(TCD)的血流动力学改变。结果 36~45岁为发病高峰年龄。最常见的首发症状包括TIA和脑梗死在内的缺血性表现共33例(51.5%);最常见的确诊症状包括TIA和脑梗死在内的缺血性表现共32例(50.0%)。有21例(32.8%)患者在首次发作时,先行TCD筛查而后经MRA或DSA全部确诊。以非脑出血症状确诊的46例患者中29例(63%)先经TCD筛查而后行DSA或MRA确诊烟雾病。结论成人型烟雾病首发及确诊症状均以缺血性血管病表现为主,TCD是筛选烟雾病的有效方法。

Clinical Characteristics of Moyamoya Disease and Analysis on Transcranial Doppler

Objective To investigate the clinical characteristics of moyamoya disease（MMD） in adult and the clinical value with transcranial Doppler（TCD）. Methods Totally 64 MMD in adult（≥ 14 years） diagnosed by using DSA and MRA were enrolled in this study. We studied the clinical characteristics of MMD in adult and＇analyze hemodynamic changes of TCD. Results 36-45 years old was an age peak. Among 64 MMD patients, cerebral ischemia occurred in 33（51.5%） and was shown as the commonest initial clinical manifestation. Cerebral isehemia occurred in 32（50.0%） and was shown as the commonest confirmed clinical manifestation. Among 21 patients （32.8%） were screened by using TCD first and then diagnosed by using DSA or MRA in the first episode.All 29 patients （63%） with non-hemorrhagic symptom were screened by using TCD first and then diagnosed by using DSA or MRA. Conclusion Ischemic stroke is the major clinical manifestation in adult MMD .TCD is an effective method of screening out moyamoya disease.