COMPUTED TOMOGRAPHIC PATTERNS OF PROVEN EMBOLIC BRAIN INFARCTIONS
COMPUTED TOMOGRAPHIC PATTERNS OF PROVEN EMBOLIC BRAIN INFARCTIONS
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DOI：
10.1002/ana.410260612
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发表时间：
1989-12-01
影响因子：
11.2
通讯作者：
MINALE, C
中科院分区：
文献类型：
--
作者：
RINGELSTEIN, EB;KOSCHORKE, S;MINALE, C
为了确定复合断层扫描上的梗死模式是栓塞的特征，而不是血流动力学或微血管病变引起的脑病变，对60例急性脑栓塞患者进行了连续系列研究。卒中的起源是栓塞性的，即排除了血流动力学和原位血栓性卒中机制。42例患者证实为栓塞性心脏病，13例患者临床表现明显。5例患者因导管相关栓塞发生卒中。计算机断层扫描显示软脑膜动脉区域性梗死55例（92%）。在5例中，梗死的大小或位置（或两者）具有腔隙的特征，尽管形状和缺乏多样性对这种解释提出了质疑。没有患者表现出低血流型梗死模式。这些发现有力地支持了以下观点：（1）除了原位血栓形成，软脑膜动脉区域性梗死是栓塞机制的指示;（2）腔隙的潜在机制几乎不是栓塞性的。
To define patterns of infarction on compound tomography that are characteristic of embolism, as opposed to hemodynamically or microangiopathically induced brain lesions, a consecutive series of 60 patients with acute brain embolism were studied. Strokes were embolic in origin; that is, hemodynamic and in situ thrombotic stroke mechanisms had been excluded. Embolically active, cardiac disease was proved in 42 and was clinically evident in 13 patients. Five patients had suffered a stroke due to catheter-related embolism. Computed tomography revealed pial artery territorial infarction in 55 patients (92%). In 5, the infarction had the size or location (or both) characteristic of lacunes, although shape and lack of multiplicity raised questions about this interpretation. No patient showed a low-flow type of infarction pattern. These findings strongly support the view that (1) except for in situ thrombosis, pial artery territorial infarctions are indicative of an embolic mechanism, and (2) that the mechanism underlying lacunes is hardly, if ever, embolic.