以单纯肢体抖动为临床表现的短暂性脑缺血发作.doc

文档介绍：以单纯肢体抖动为临床表现的短暂性脑缺血发作
王晓芳张本恕
(天津医科大学总医院神经内科,天津 300052)
[摘要] 目的:以单纯肢体抖动为临床表现的短暂性脑缺血发作(limb-shaking transient ischemic attack,LS-TIA)临床少见,本文旨在提高临床医师对这一症候的认识。方法:总结我院患者3例,分别行颈部血管超声、经颅多普勒超声、核磁血管成像、头部核磁共振及弥散加权成像、脑电图、数字减影血管照影、CT灌注成像检查。结果:均表现为发作性短暂不能控制的肢体抖动,持续数秒钟至一分钟。3例发作前均有明显诱因。全部患者均有抖动肢体对侧至少1条以上颅内和/或颅外颈内动脉重度狭窄或闭塞。头部核磁共振显示3例病人抖动肢体对侧有脑梗死。脑电图无痫样放电。结论:以单纯肢体抖动为临床表现的短暂性脑缺血发作通常提示病人的大血管有严重的狭窄或闭塞,均存在脑卒中的危险因素。低灌注是其最可能的发病机制。
[关键词] 肢体抖动;短暂性脑缺血发作;低灌注
[中图分类号] [文章标识码]A [文章编号]
Clinical manifestations of pure limb-shaking transient ischemic attacks
Wang Xiao-fang,Zhang Ben-shu
(Department of Neurology,General Hospital of Tianjin Medical University,
Tianjin 300052)
ABSTRACT Objective:Limb-shaking transient ischemic attack(LS-TIA)is an unusual manifestation of ischemic is important to recognize this form of carotid transient ischemic attack..Methods:We enrolled 3 patients with LS- vascular ultrasound ,transcranial Doppler(TCD),ic resonance angiography(MRA),brain ic resonance imaging(MRI)+diffusion weight imaging(DWI),eletroencephalography(EEG),digital substract angiography(DSA),CT perfusion imaging were performed in 3 :The basic features included a paroxysmal,brief,involuntary limb shaking which last about several seconds to a patients had obvious precipitating contralateral internal cervical artery or middle cerebral a