脊髓梗死:临床、MRI表现和短期预后

作     者：Masson C. Pruvo J.P. Meder J.F. 夏峰 

作者机构：Department of Neurology Beaujon Hospital 100 bd du G'en. Lecler c 92110 Clichy France 

出 版 物：《世界核心医学期刊文摘（神经病学分册）》 (Digest of the World Core Medical Journals:Clinical Neurology)

年 卷 期：2005年第1卷第2期

页      面：35-36页

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：MRI 动脉供血区 胸段 颈段 轴切面 膀胱功能障碍 预后良好 受损者 梗死范围 病例个案 

摘      要：Background: Most studies on spinal cord infarction have been conducted in sing le centres; they usually consisted of case reports, or of larger series of patie nts recruited over a large period of time, with heterogeneous diagnostic procedu res. Therefore, the clinical and radiological presentation of spinal cord infarc ts and their short term outcome remain poorly understood. Objective: To define c linical and magnetic resonance imagin g (MRI) findings, and short term outcome in patients with spinal cord infarcts. Methods:The authors prospectively included patients within 10 days of onset. An MRI scan was required and repeated when initially normal. Results: Twenty eight consecutive patients were included over a 24 month period in 16 neurological cen tres. The infarct was cervical in seven patients, thoracic in three, thoracolumb ar in 15, and restricted to the conus in three. On axial MRI scans the infarct w as located in the central territory of the anterior spinal artery in 21 patients , and in the peripheral arterial territory in three. At month two, 15 patients h ad a good outcome and 13 had a poor outcome, including three deaths. Patients wh o, at onset, could not walk, had bladder dysfunction, or proprioceptive deficits were more likely to have a poor outcome. At month two, pain had occurred in 10 of the 25 survivors and was associated neither with the initial severity, nor th e extent of the infarct on MRI. Conclusion: The two month outcome mainly depends on the initial severity of the neurological deficit; however, a few patients wi th a severe impairment at onset had a good outcome, especially when propriocepti on remained normal at onset. The study does not support the hypothesis that pain occurs more frequently in small spinal infarcts.