基底动脉闭塞的DSA分析

目的探讨脑干梗死经DSA全脑血管造影证实基底动脉闭塞后的临床与预后,以期对临床治疗有一定的指导意义。方法选取14例在临床中发现并经脑血管造影证实为基底动脉闭塞而临床症状轻微的患者。分析基底动脉闭塞后的临床表现与侧支代偿之间的关系。结果(1)基底动脉近端闭塞,临床表现多以眩晕发作为主(占91%);中段或远端闭塞,则多表现为间断性意识障碍(占66.7%)。(2)基底动脉近端闭塞,侧支血流多由颈外动脉和锁骨下动脉分支及椎动脉颅外段的肌支或脊髓前动脉代偿供血;基底动脉中、远段闭塞,侧支血流多由小脑后下动脉与小脑上动脉吻合(占100%)。结论基底动脉闭塞若侧支代偿充分,可不表现明显的脑干缺血表现或表现轻微。内科治疗效果较好。

The analys is of brain stem infarction with DSA

Objective To research the clinic and prognosis of brain stem infarction from the basilar artery occlusion by four-brain artery angiography for giving some advice to treatment.Methods 14 cases of patients with vertebral-basilar artery occlusion was included,among them,6 cases with proximal basilar artery occlusion,5 cases with middle basilar artery occlusion,3 cases with distal basilar artery occlusion.And then exploring the relationship between the clinic behavior and branch circulation in the different period of occlusion.Results (1)the clinical behavior of the patients with proximal basilar artery occlusion was almost faint(91%).And that with the middle and distal clisorelers was almost discontinued coma(66.7%);(2)Of proximal basilar artery occlusion,the compensation was almost the branch of ECA,Sub clavicle artery,and the muscle or the spinal branch of vertebra artery:of intracranial vertebra artery and basilar artery basilar;Of middle and distal intracranial basilar artery occlusion,the compensation was almost the anastomosis of PICA betweem SCA(100%).Conclusion Basilar artery occlusion may have little,or even no clinical manifestation of ischemic in the brain stem,internal medical treatment may give the patient good outcome.