一个急性中风队列中单侧感觉缺失的发生率、危险因素、解剖部位和病程

作     者：Ringman J.M. Saver J.L. Woolson R.F. 邓剑平 

作者机构：Department of Neurology Univ. of California Los Angeles 710 Westwood Plaza Los Angeles CA 90095- 1769 United States Dr. 

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1期

页      面：48-49页

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

主　　题：急性中风 感觉缺失 病变位置 中风患者 脑损伤 多中心临床试验 神经解剖 优势手 抗凝剂 损伤后 

摘      要：Objective: To delineate the frequency, course, risk factors, and neuroanatomy of hemispatial neglect in a large stroke cohort. Methods: One thousand two hundred eighty one patients with acute stroke were enrolled in a multicenter trial of an anticoagulant. Presence and severity of neglect were assessed with the NIH Stroke Scale (NIHSS) neglect item, assessing tactile extinction and visuospatial neglect at entry, daily for 1 week, and at 3 months. Head CT scans were obtained on day 7, and infarct location and size were characterized. Results: Neglect was common at presentation, occurring in 43% of right brain lesioned (RBL) patients and 20% of left brain lesioned (LBL) patients (p 0.001). At 3 months, neglect was present in 17% of RBL patients and in 5% of LBL patients (p 0.001). In RBL patients, neglect was most frequently associated with lesions involving the (in descending order) temporal, parietal, frontal, occipital lobes, basal ganglia, and thalamus. Neglect was more common and persistent with cortical than with subcortical lesions. Increasing age was associated with increased risk of neglect in RBL patients, whereas gender and handedness did not significantly affect neglect frequency. Conclusions: This series confirms that hemispatial neglect may occur with damage to several supratentorial structures but is most common and persistent with lesions of the right temporoparietal cortex. Increasing age is associated with neglect, parti cularly after right brain lesions. Gender and handedness do not exert a marked effect on the likelihood of the occurrence of neglect.