| 摘要: |
| 目的 报告2例Percheron动脉梗死病例，并对86例Percheron动脉梗死病例进行文献回顾，总结该病的临床特点。方法 报告西安医学院第一附属医院收治的2例Percheron动脉梗死患者的临床诊治过程和转归。通过查阅国内外文献获得86例Percheron动脉梗死病例数据，对88例患者的临床数据进行统计分析。结果 纳入Percheron动脉梗死患者共88例，男41例（46.6%）、女47例（53.4%），年龄为6～93（58.7±18.9）岁。Org 10172急性脑卒中治疗试验分型为小动脉闭塞23例（26.1%）、心源性栓塞22例（25.0%）、其他原因22例（25.0%）、不明原因21例（23.9%）。未行静脉溶栓者80例（90.9%）。急性起病83例（94.3%）。临床表现为意识障碍80例（90.9%）、眼肌麻痹41例（46.6%）、言语障碍（构音障碍或丘脑性失语）37例（42.0%）、肢体运动功能障碍34例（38.6%）、瞳孔异常34例（38.6%）、头晕15例（17.0%）、记忆减退14例（15.9%）、共济失调5例（5.7%）、面神经麻痹3例（3.4%）。梗死部位以单纯丘脑梗死最多（44例，50.0%），其次为丘脑合并中脑梗死（35例，39.8%）。影像学表现为典型中脑“V”字征14例（15.9%）。治疗后病情好转73例（83.0%），死亡11例（12.5%），再发梗死2例（2.3%），病情无变化2例（2.3%）。年龄和梗死部位与预后有关（均P<0.01）。结论 Percheron动脉梗死早期症状多变，急性期弥散加权成像提示丘脑和/或中脑可见高信号，可有典型中脑“V”字征。早期Percheron动脉梗死治疗可用静脉溶栓和其他缺血性脑卒中治疗方案，其预后与年龄和梗死部位有关。 |
| 关键词: Percheron动脉梗死 丘脑旁正中动脉 丘脑腹内侧综合征 丘脑旁正中综合征 |
| DOI：10.16781/j.CN31-2187/R.20230376 |
| 投稿时间：2023-07-03修订日期：2023-11-09 |
| 基金项目:西安市科技计划项目（20YXYJ0007（2））. |
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| Artery of Percheron infarction: a report of 2 cases and literature review |
| WEI Wei1,ZHANG Bei2,WANG Lin2* |
(1. Department of Neurology, The Third Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 201805, China;
2. Department of Neurology, The Frist Affiliated Hospital of Xi'an Medical University, Xi'an 710077, Shaanxi, China
*Corresponding author) |
| Abstract: |
| Objective To report 2 cases of artery of Percheron (AOP) infarction and conduct a literature review of 86 cases of AOP infarction, summarizing the clinical characteristics of the disease. Methods The clinical diagnosis, treatment and prognosis of 2 patients with AOP infarction who were treated in The Frist Affiliated Hospital of Xi'an Medical University were reported. The data of 86 cases of AOP infarction were obtained from the literatures at home and abroad. All the clinical data were statistically analyzed. Results A total of 88 AOP patients were enrolled, including 41 males (46.6%) and 47 females (53.4%), with an average age of (58.7±18.9) years old, ranging from 6 to 93 years old. The etiology of acute ischemic stroke was classified according to the Trial of Org 10172 in Acute Stroke Treatment classification:small artery occlusion in 23 patients (26.1%), cardiac embolism in 22 patients (25.0%), other cause in 22 patients (25.0%), and unknown cause in 21 patients (23.9%). There were 80 cases (90.9%) without intravenous thrombolysis and 83 cases (94.3%) with acute onset. There were 80 cases (90.9%) with consciousness disorder, 41 cases (46.6%) with ophthalmoplegia, 37 cases (42.0%) with speech disorder (dysarthria or thalamic aphasia), 34 cases (38.6%) with limb motor dysfunction, 34 cases (38.6%) with abnormal pupils, 15 cases (17.0%) with dizziness, 14 cases (15.9%) with memory loss, 5 cases (5.7%) with ataxia, and 3 cases (3.4%) with facial nerve paralysis. The most common infarction sites were simple thalamic infarction (44 cases, 50.0%), followed by thalamic infarction combined with mesencephalic infarction (35 cases, 39.8%). The typical midbrain "V" sign was found in 14 cases (15.9%). After treatment, 73 cases (83.0%) were improved, 11 cases (12.5%) died, 2 cases (2.3%) had recurrent infarction, and 2 cases (2.3%) had no change. The age and infarction site were related to the prognosis of patients (both P<0.01). Conclusion The early symptoms of AOP infarction are variable. Diffusion weighted imaging in the acute phase suggests that high signals can be seen in the thalamus and/or midbrain, and there may be a typical "V" sign in the midbrain. Early AOP infarction can be treated with intravenous thrombolysis and other ischemic stroke treatments. The prognosis is related to the age and infarction site. |
| Key words: artery of Percheron infarction para-thalamic median artery ventromedial thalamic syndrome para-thalamic median syndrome |
