摘要
目的探讨慢性颈动脉完全闭塞后的脑循环与代谢变化。方法动态研究慢性颈动脉完全闭塞患者的脑循环、脑代谢、临床表现及认知功能改变,并与急性颈动脉完全闭塞患者进行对比。结果慢性颈动脉完全闭塞患者无明显局灶神经系统及高级脑功能受损的症状及体征,头部MRI检查无明显影像学改变,但均存在轻度认知功能障碍。1例双侧颈总动脉慢性完全闭塞患者DSA检查发现存在右侧锁骨下动脉-颈内动脉颅内段侧支途径。运用1HMRS检测患者双侧海马的NAA/Cr比值、Cho/Cr比值及Glx-α/Cr比值,存在差异。结论慢性颈动脉完全闭塞患者除存在传统的侧支循环外,还可建立锁骨下-颈动脉的血管自身搭桥循环路径,长期无明显脑功能受损的临床表现。轻度认知障碍是代偿不全的表现。1HMRS检查可发现人脑代谢的改变,行外科干预治疗可能有助于改善认知功能及脑代谢。
Objective To discuss the cerebral circulation and metabolism of chronic carotid artery occlusion. Methods Cerebral circulation, cerebral metabolic changes, clinical manifestations and cognitive functions were studied in patients with chronic carotid occlusion and acute carotid occlusion. Results Patients with chronic carotid artery occlusion had no obvious symptoms and signs of nervous system and senior brain function. Patients had mild cognitive dysfunctions, but there were no large infarct lesions in MRI. DSA examination revealed right subclavian artery-intracranial internal carotid artery collateral circulation in one patient with chronic bilateral carotid artery occlusion. NAA/Cr ratios, Cho/Cr ratios and Glx-α/Cr ratios of ^1HMRS were different in patientsbilateral hippocampus. Conclusions Patients with chronic carotid artery occlusion did not reveal obvious clinical manifestations for a long time, and established the vascular bypass from subclavian artery to carotid artery besides the traditional collateral circulation. Mild cognitive impairment was expressed as an incompletely compensatory character. I HMRS can find human cerebral metabolic changes. At the same time,patients with surgical treatment may improve cognitive function and metabolism of the brain.
出处
《中风与神经疾病杂志》
CAS
CSCD
北大核心
2008年第2期194-197,共4页
Journal of Apoplexy and Nervous Diseases
关键词
颈动脉完全闭塞
脑循环
脑代谢
磁共振波谱
Carotid occlusion
Cerebral circulation
Cerebral metabolism
Proton magnetic resonance spectroscopy
