老年人无症状性脑梗死的病因及影像学研究

目的 研究老年人无症状性脑梗死的病因及神经影像学特点.方法 对住院的急性脑卒中患者及健康查体中的受检对象进行CT或MRI检查,以发现确认陈旧性梗死灶,并询问病史以排除以往有症状性脑卒中,同时进行影像学分类及病因追查.结果 影像学改变分为两类:一类是无症状性腔隙性脑梗死,占90.05%;另一类是无症状性小梗死,占9.5%.前者梗死部位多在基底节、内囊、脑干,后者多在脑叶,其病因主要是高血压、脑动脉硬化症、糖尿病及冠心病伴房颤等.结论 老年人无症状性脑梗死以腔隙性梗死为多,认为CT及MRI是确认无症状性脑梗死的唯一检查方法;对高危因素的老年人进行普查和积极对因治疗对预防无症状性脑梗死或症状性脑梗死有重要临床价值.

Etiology and image research of asymptomatic cerebral infarction of the elderly

Objective To explore the etiology and image characteristics of asymptomatic cerebral infarction(ACI) of the elderly.Methods Subjected acute stroke patients in hospital and controls who received physical examine to CT or MRI test to detect the latent former infarction kitchen,history taking to eliminate symptomatic stroke,and image classification together with etiology investigation.Results Two groups were formed according to image classification,including asymptomatic lacuna cerebral infarction(90.05%) and asymptomatic micro-infarction(9.5%).Most of the infarction position of the former lies in basal ganglia,internal capsule,and brain stem while the later in brain lobi.The dominating cause of ACI involves hypertension,cerebral arteriosclerosis,diabetes,or coronary heart disease complicated by atrial fibrillation.Conclusion Lacuna cerebral infarction was major manifestation in asymptomatic cerebral infarction of the elderly,Image examine(CT or MRI) was testified to be the exclusive method to diagnose asymptomatic cerebral infarction.For the prevention of asymptomatic or symptomatic cerebral infarction,it has important clinical value to apply general investigation and positive pathogeny therapy to the elderly exposed to high risk factors.