【摘要】 目的探讨基底节病变致儿童急性偏瘫的临床特点。方法回顾分析12例基底节病变所致的脑梗死的症状、体征、头颅MRI、MRA、CT、TCD、EEG检查的结果及治疗效果。结果本组病例头颅MRI均异常,提示基底节区有缺血L性梗死灶,病灶位于偏瘫对侧,与临床定位相符。临床表现均以急性偏瘫为首发症状,无伴意识障碍,无颅内高压症状,无言语异常。行CT检查的11例中,6例双侧基底节区有点状或片状钙化。MRA检查9例均无异常。EEG检查的9例中4例异常。TCD检查11例中6例异常,提示双侧大脑中动脉血流速度加快和(或)病灶对侧大脑前动脉血流速度加快。经治后2～10d肌力有所恢复,6～40d肌力恢复至V-级或正常,肌力恢复均下肢早于上肢,中枢性面瘫最后恢复。结论婴幼儿颅脑外伤程度轻,但有明显的脑梗死症状者,基底节梗死可能性大,基底节有钙化灶的婴幼儿在轻微外伤后易出现急性偏瘫。更多还原

【Abstract】 Objective To study the clinical characteristics of acute hemiplegia syndrome in children with basal ganglia lesion.Methods Symptoms,signs and prognosis were reviewed retrospectively in 12 children with cerebral infarction caused by basal ganglia lesion.Twelve patients were studied by MRI,MRA,CT,TCD and EEG as the combined diagnostic methods.Results All cerebral infarctions occurred in only one side of basal ganglia,resulting in acute hemiplegia but no changes of consciousness or no sign of intercranial hypertension.CT scan showed calcification of bilateral basal ganglia in 6 cases.MRA showed no abnormalities in 9 cases.EEG showed abnormalities in 4 cases.TCD showed higher blood flow velocity of bilateral middle cerebral artery and/or higher blood flow velocity of contralateral anterior cerebral artery.The infants recovered well after treatment.Conclusion The occurrence of cerebral lacunar infarction is associated with basal ganglia calcification.Infants with the basal ganglia calcifications are prone to acute hemiplegia after minor cerebral trauma.更多还原