回顾性分析20例胼胝体梗死患者的临床特点、治疗和预后

目的探讨胼胝体梗死的病因、临床特点、影像学表现以及治疗预后,提高对该疾病的认识。方法收集2006年4月～2008年4月住院治疗的20例胼胝体梗死患者,并对其临床资料进行回顾性分析。结果50～80岁为该病高发年龄,其主要的危险因素是高血压、高脂血症和糖尿病,动脉粥样硬化是其主要的病因。最主要的临床表现为运动障碍,语言障碍、共济失调、感觉障碍、智能障碍等。影像学显示梗死部位以膝部、体部多见,常累及基底节区、额叶、顶叶、颞叶、枕叶、脑干等部位。其中有6例行头MRA证实存在动脉狭窄或闭塞。经治疗后16例患者肢体运动功能好转,3例恶化出现意识障碍,1例无明显变化。有6例存在智能障碍,其中4例无变化或降低,2例轻度改善。结论胼胝体梗死因部不同临床表现不同,头MRI特别是DWI对胼胝体梗死定位诊断具有指导作用。肢体运动功能较高级神经功能预后好。

Clinical manifestations and prognosis analysis of the corpus callosal infarction

Objective To study etiological factor,clinical manifestions,imaging findings and prognosis of corpus callosal infarction ,improving recognition of this disease. Methods Retrospective analysis was undertaken in 20 cases with corpus callosal infarction,hospitalized from April 2006 to April 2008. Results The corpus callosal infarction had a high incidence rate at the age of the 50-80 years,the high risk factors are hypertension,hyperlipoidemia and diabetes.The major etiology was atherosis.and its major clincal manifestations were motor impairment,language disorder,ataxia,sensory disturbance,disturbance of intelligence and so on. MRI showing：the main sites of infarction were genu and body,basal ganglia,frontal lobe, parietal lobe,temporal lobe and occipital lobe,brain stem were also involved. The arteries stenoses or occlusions were confirmed by MRA in six cases. After treatment limb motor function improved in 16 patients,conscious disturbance aggravated in 3 patients,no improvement in 1 patient. There are 6 cases with cognitive impairement,4 of whom unchanged or decreased,only 2 cases mild improvement. Conclusion The clinical manifestations of corpus callosal infarction vary with lesion sites involved, and head MRI,especially DWI is helpful to loccalized the site of the lesions in corpus callosal. Limb motor function was better prognosis than the cognitive and behavior dysfunction.