巨细胞动脉炎的卒中模式大多涉及分水岭区域

IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY
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引用次数: 0

摘要

背景与巨细胞动脉炎(GCA)相关的中风非常罕见,且预后较差。缺血机制之一是动脉管壁受炎症浸润和内膜增生导致管腔狭窄,从而导致远端血流减少。结果 在 75 例 GCA 相关脑卒中病例中,前区和后区受累的比例分别为 48% 和 62.6%。高达 88.9%的前区卒中可能涉及 WA。后区的 WA 病变情况如下:单/双侧小脑中部梗(MCP)病变占 25.5%,非楔形小脑病变占 46.8%,合并病变占 61.7%,但可信度较低。几乎总是观察到传入动脉狭窄或闭塞。讨论尽管动脉区域分配存在局限性,尤其是在后循环,但缺血性病变主要发生在西澳大利亚州。MCP病变是典型的WA病变,是GCA的高度特征。低流量下游局灶性狭窄是 GCA 中风的主要缺血机制,但不是唯一机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Stroke pattern in giant-cell arteritis mostly involves watershed areas

Context

Stroke related to giant cell arteritis (GCA) is rare and is associated with a poor outcome. One of the putative ischemic mechanisms is narrowing of the arterial lumen due to wall infiltration by inflammation and intimal proliferation, leading to reduced distal blood flow. It was hypothesized that GCA-related stroke could predominate in watershed areas (WA).

Methods

Literature review including all cases of GCA-related stroke with brain images.

Results

Among 75 cases of GCA-related stroke, the anterior and posterior territories were involved in 48 % and 62.6 %, respectively. Up to 88.9 % of cases of anterior stroke probably involved WA. WA lesions in the posterior territories were as follows: uni/bilateral middle cerebellar peduncle (MCP) lesions in 25.5 %, and with less confidence, non-wedge-shaped cerebellar lesions in 46.8 %, or combined lesions in 61.7 %. Stenosis or occlusion of the afferent artery was almost always observed. A few lesions were not easily explained by low flow.

Discussion

Despite the limitations of arterial territory allocation especially in the posterior circulation, ischemic lesions mainly occurred in WA. MCP lesions, which were typically WA, were highly characteristic of GCA. Low flow downstream focal stenosis was the main, but not the unique, ischemic mechanism of GCA stroke.

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来源期刊
Clinical Neurology and Neurosurgery
Clinical Neurology and Neurosurgery 医学-临床神经学
CiteScore
3.70
自引率
5.30%
发文量
358
审稿时长
46 days
期刊介绍: Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.
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