急性胼胝体梗死33例临床及影像学分析

目的探讨急性胼胝体梗死的临床及影像学特征：方法回顾性分析2006年4月-2010年4月安徽医科大学附属省立医院1609例脑梗死患者中，经MRI确诊的33例胼胝体梗死患者的临床及影像学资料结果①该病发生率为2．05％（33／1609）；发病年龄为（63±9）岁，主要危险因素是高血压、高脂血症和糖尿病。②33例中，以肢体瘫痪（93．9％）和认知功能下降（57．6％）最为多见，其次是面、舌瘫（48．5％），共济失调（45．5％），感觉障碍（39．4％），再次是情感障碍和语言障碍（均为30.3％），而异己手综合征最少见（9．1％）。（3）33例通过MRI检出病灶42个，以体部（42．9％）、压部（35．7％）多见。6例为单纯胼胝体梗死，27例合并颅内其他部位梗死，最多见于基底核区（75．8％）。单侧梗死患者（24／33）多于双侧（9／33），P〈0．01。④15例行血管造影检查（MRA／CTA／DSA），大腩的动脉狭窄6例，闭塞3例；胼周动脉狭窄3例，闭塞2例；大脑中动脉狭窄1例，大脑后动脉狭窄3例，闭塞2例；血管形态正常者2例。结论胼胝体梗死发生率相对低，临床表观复杂多样，应重视认知功能的下降和异己手综合征，MRI对胼胝体梗死定位诊断具有重要意义。

Acute infarct of the corpus callosum: a clinical and imaging analysis of 33 patients

Objective To investigate the clinical and imaging features of acute infarct of the corpus eallosum. Methods The clinical and imaging data of 33 patients with corpus callosal infarction diagnosed hy MRI from L609 patients in Anhui Provincial Hospital from April 2006 to April 2010 were analyzed retrospectively. Results （1）The incidence of the disease was 2.05%, and the average age of onset was 63 ± 9 years. The major risk factors were hypertension, hyperlipoidemia, and diabetes. （2）Among the 33 patients, limb paralysis （93.9%） and cognitive decline （57.6%） were the most common, while alien hand syndrome was most rare （9.1% ） clinical symptoms. （3）MRI detected 42 foci in the corpus callosum of 33 patients, and they maiulv located in the body and splenium of corpus callosum. Six patients had corpus callosal infarction only and 27 patients eomplieated infaretions in the other part of the brain, mostly in basal ganglia （75.8%）. The patients with unilateral infarction （24/33） were more than those with bilateral infaretion （9/33; P 〈0. 05）. Angiographies （MRA CTA or DSA） were performed in 15 patients. Six patients had stenosis and 3 had occlusion of anterior cerebral artery; 3 had stenosis and 2 had oclusion of pericallosal artery; one had nliddle cerebral artery, stenosis, 3 had stenosis, and 2 had occlusion of posterior cerebral artery; 2 had normal vascular morphology. Conclusion The incidence of corpus callosal iMarction is relatively low while its clinical manifestations are co,nplex and diverse. Attention should be paid to the cognitive decline and alien hand syndrome. MRI exanfination has great significance on the diagnosis and localization for corpus callosal infarction.