NIHSS评分为0分的急性脑梗死患者的临床特点

目的探讨美国国立卫生研究院脑卒中量表（National Institutes of Health Stroke Scale Score，NIHSS）评分为0分而磁共振弥散加权像显示急性脑梗死病灶患者的临床特点。方法对经NIHSS评分为0分、磁共振弥散加权像显示急性脑梗死病灶的发病48h内住院患者的临床症状、体征、影像学特点进行分析。结果共纳入急性脑梗死患者35例，主要症状有头痛、眩晕、恶心呕吐、肢体麻木、肢体无力。磁共振弥散加权像上均显示急性前循环梗死2（）例（57．1％），后循环梗死11例（31．4％），前后循环脑梗死3例（8．6％o）。26例脑梗死患者显示单发梗死病灶（74．3％），其中穿支动脉小梗死19例（54．3％）。结论青年型脑梗死以男性多见，高血压病在致病危险因素方面男女均占据主要地位，男性还应警惕嗜烟酒及糖尿病。在TOAST分型NIHSS评分为0分不代表无脑梗死发生，主要为单发穿支动脉小梗死病灶。NIHSS评分项目不能很好地评价后循环急性梗死所引起症状和体征。

Clinical and imaging characteristic of stroke patients with zero on the NIHSS

Objective To investigat the clinical symptoms and imaging characteristic of patients with a cute brain infarction and a National Institutes of Health Stroke the clinical symptoms, signs, lesion location and imaging were Scale Score （NIHSS） of zero. Methods Data of collected from all patients with acute neurologi- cal symptoms within 48 hours, the National Institutes of Health Stroke Scale Score of 0, and an acute infarc- tion on MR diffusion weighted imaging （DWI） from 2010 to 2013. Results 35 patients met inclusion criteria. Symptoms frequently experienced were vertigo, headache, nausea, numb and subtle limb weakness. 20 pa- tients had an acute infarction of anterior circulation and I I patients had an infarction of posterior circulation. Single small perforating artery infarction was demonstrated on MR diffusion weighted imaging in 19 patients. Conclusions Zero on the NIHSS does not equal the absence of stroke. The most common type was small per- forating artery infarction. The ischemic symptoms caused hy posterior circulation does not measure well on NIHSS.