皮层下动脉硬化性脑病的早期诊断

目的研究皮层下动脉硬化性脑病（SAE）的临床及影像学特点，对其作出早期诊断及早期干预，提高患者生活质量。方法追踪108例高血压合并高血压合并多发性腔隙性脑梗死患者5年后症状、体征和头颅CT、MRI的变化。结果88例（81．5％）病例出现锥体束损害、假性球麻痹、感知行为异常、痴呆等皮层下动脉硬化性脑病临床表现，78例（72.2％）患者出现典型的（Ⅲ型）Binswanger病的影像学改变。结论皮层下动脉硬化性脑病为颅内小动脉硬化慢性病程的最终结局。头颅CT、MRI的影像学改变早于临床症状的出现，为临床早期药物干预提供有力依据。

Early diagnosis of subcortical arteriosclerotic encephalopathy

Objective To study the clinical and image characteristics of subcortical arteriosclerotic encephalopathy （SAE） in order to make early diagnosis and intervention. Methods Symptoms and signs, and changes in head CT or MRI of 108 patients with hypertension and muhiple cerebral infarction in previous 5 years were traced. Results Clinical manifestations of SAE including pyramidal tract lesion, supranuclear paralysis, abnormal sensation and aphrenia appeared in 88 cases （81.5%） and the typical image profile of type Ⅲ Binswanger disease in 78 cases （72. 2% ）. Conclusion Changes of head CT and MRI images appear earlier than those of clinical manifestations and indicate early clinical intervention.