Mối liên quan giữa lâm sàng và hình ảnh học của nhồi máu não tái phát do tổn thương động mạch não giữa=Relationship between clinical and imaging of reccurent MCA infarction

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Huyền Nguyễn, Văn Đức Phan

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Thần kinh học, 2024

Mô tả vật lý: tr.65-72

Bộ sưu tập: Metadata

ID: 241667

Thêm vào giỏ

Evaluate the relationship between clinical and imaging of recurrent cerebral infarction dued to MCA damaged. Subjects and method: A cross-sectional, descriptive study of 77 patients with recurrent cerebral infarction dued to damaged middle cerebral artery treated at the Neurological Center, Bach Mai Hospital from July 2021 to August 2022. Results: Motor paralysis of the hemibody on the opposite side of the injury, paralysis of the central VII nerve on the opposite side of the injury and decreased sensation of the hemibody on the opposite side of the injury are symptoms seen at a high rate, accounting for 100% respectively
90.9% and 77.9%. The proportion of patients with consciousness disorders from the beginning accounted for 49.4% of patients, 2 patients were in a deep coma when hospitalized (accounting for 2.6%). Language disorders including Broca’s language disorder, Wernicke’s language disorder and mixed language disorder accounted for 20/77 patients (26.0%). Horizontal eye and head deviation, circular muscle disorders, loss of attention on one side of the body, and hemianopia account for 32.5% respectively
26.0%
22.1%
26.0%. 7.8% of patients had mental disorders and 14.3% of patients had seizures when hospitalized
The symptoms of headache, nausea, and vomiting accounted for 45.5% and 31.2%, respectively. Patients with symptoms clustered into Gerstman syndrome and Anton - Babinski syndrome account for a low rate: 9.1% and 11.7%. The most damaged arterial branch is the M1 branch with 31 patients, accounting for 40.2%
Oblique branches of the middle cerebral artery or putamen-striatum branches account for 32.5%. Only 4 patients had damage to branches M3 - M4 (accounting for 5.2%). The number of patients with damage to the M1 branch who had consciousness disorders accounted for the highest rate of 33.8%, with no patients with damage to the deep branch having consciousness disorders. Symptoms at hospital admission: consciousness disorders, speech disorders, turning eyes and head to the damaged hemisphere have a statistically significant relationship with the location of the damaged middle cerebral artery branch (p <
0.05) Conclusion: Recurrent cerebral infarction due to damage to the middle cerebral artery has diverse clinical symptoms, depending on the damaged middle cerebral artery branch.Nhận xét mối liên quan giữa một số đặc điểm lâm sàng và hình ảnh học của nhồi máu não tái phát do tổn thương động mạch não giữa. Đối tượng và phương pháp nghiên cứu: nghiên cứu mô tả cắt ngang được thực hiện trên 77 bệnh nhân nhồi máu não tái phát do tổn thương động mạch não giữa được điều trị tại trung tâm Thần kinh - Bệnh viện Bạch Mai từ tháng 7 năm 2021 đến tháng 8 năm 2022. Kết quả: Liệt vận động nửa người đối bên tổn thương, liệt dây VII trung ương đối bên tổn thương và giảm cảm giác nửa người đối bên tổn thương là các triệu chứng gặp với tỷ lệ cao, chiếm lần lượt là 100%
90,9% và 77,9%. Tỷ lệ bệnh nhân có rối loạn ý thức ngay từ đầu chiếm 49,4% số bệnh nhân, 2 bệnh nhân hôn mê sâu khi nhập viện (chiếm 2,6%). Rối loạn ngôn ngữ bao gồm rối loạn ngôn ngữ Broca, rối loạn ngôn ngữ Wernicke và rối loạn ngôn ngữ hỗn hợp chiếm 20/77 bệnh nhân (26,0%). Quay mắt quay đầu, rối loạn cơ tròn, mất chú ý nửa người, bán manh chiếm tỷ lệ lần lượt là 32,5%
26,0%
22,1%
26,0%. Có 7,8% bệnh nhân có các rối loạn tâm thần và 14,3% bệnh nhân có co giật khi nhập viện
các triệu chứng đau đầu, buồn nôn, nôn chiếm lần lượt 45,5% và 31,2%. Bệnh nhân có triệu chứng tập hợp thành hội chứng Gerstman và hội chứng Anton – Babinski chiếm tỷ lệ thấp: 9,1% và 11,7%. Nhánh động mạch bị tổn thương nhiều nhất là nhánh M1 với 31 bệnh nhân chiếm 40,2%
các nhánh xiên của động mạch não giữa hay nhánh nhân đậu – thể vân chiếm 32,5%. Chỉ có 4 bệnh nhân tổn thương nhánh M3 – M4 (chiếm 5,2%). Số bệnh nhân tổn thương nhánh M1 có rối loạn ý thức chiếm tỷ lệ cao nhất 33,8%, không có bệnh nhân tổn thương nhánh sâu nào có rối loạn ý thức. Các triệu chứng lúc vào viện: rối loạn ý thức, rối loạn ngôn nhữ, quay mắt quay đầu về bán cầu tổn thương có mối liên quan có ý nghĩa thống kê với vị trí nhánh động mạch não giữa bị tổn thương (p <
0,05). Kết luận: Nhồi máu não tái phát do tổn thương động mạch não giữa có triệu chứng lâm sàng đa dạng, tùy thuộc vào nhánh động mạch não giữa bị tổn thương Từ khóa: nhồi máu não, tái phát, động mạch não giữa, hình ảnh học.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR