后循环缺血性卒中中西医临床研究进展
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摘要
后循环缺血性卒中是指发生在椎基底动脉系统供血区的梗死,在发病病因、症状表现、临床评价、诊断鉴别和治疗措施等方面与前循环缺血性卒中存在一定差异。本文就近几年来国内外中医及西医有关后循环缺血性卒中的临床研究进行综述。
Posterior circulation ischemic stroke refers to the infarction occurring in the blood supply area of the vertebrobasilar artery system. There are some differences between posterior circulation ischemic stroke and anterior circulation ischemic stroke in pathogeny,symptoms,clinical evaluation,diagnosis and treatment. In this paper,recent progress in the treatment of posterior circulation ischemic stroke at home and abroad is reviewed.
Posterior circulation ischemic stroke refers to the infarction occurring in the blood supply area of the vertebrobasilar artery system. There are some differences between posterior circulation ischemic stroke and anterior circulation ischemic stroke in pathogeny,symptoms,clinical evaluation,diagnosis and treatment. In this paper,recent progress in the treatment of posterior circulation ischemic stroke at home and abroad is reviewed.
引文
[1]Gulli G,Marquardt L,Rothwell PM,Markus HS.Stroke risk after posterior circulation stroke/transient ischemic attack and its relationship to site of vertebrobasilar stenosis pooled data analysisfromprospective studies.Stroke(2016)44(3):598-60410.1161/STROKEAHA.112.669929.
[2]Labropoulos N,Nandivada P,Bekelis K.Stroke of the posterior cerebral circulation.Int Angiol(2014)30(2):105-14.
[3]Gao LY,Guo X,Zhou JJ,Zhang Q,Fu J,Chen WJ,et al.Basilar artery fenestration detected with CT angiography.Eur Radiol(2015)23(10):2861-710.1007/s00330-013-2890-2.
[4]Griessenauer CJ,Loukas M,Tubbs RS,Cohen-Gadol AA.The artery of Percheron:an anatomic study with potential neurosurgical and neuroendovascular importance.Br J Neurosurg(2016)28(1):81-510.3109/02688697.2013.812181.
[5]Lazzaro NA,Wright B,Castillo M,Fischbein NJ,Glastonbury CM,Hildenbrand PG,et al.Artery of Percheron infarction:imaging patterns and clinical spectrum.AJNR Am J Neuroradiol(2012)31(7):1283-910.3174/ajnr.A2044.
[6]Forster A,Nolte I,Wenz H,Al-Zghloul M,Kerl HU,Brockmann MA,et al.Anatomical variations in the posterior part of the circle of Willis and vascular pathology in bilateral thalamic infarction.J Neuroimaging(2015).10.1111/jon.12022.
[7]Miralles M,Dolz JL,Cotillas J,Aldoma J,Santiso MA,Giménez A,et al.The role of the circle of Willis in carotid occlusion:assessment with phase contrast MR angiography and transcranial duplex.Eur J Vasc Endovasc Surg(1995)10(4):424-3010.1016/S1078-5884(05)80164-9.
[8]Hong JM,Chung CS,Bang OY,Yong SW,Joo IS,Huh K.Vertebral artery dominance contributes to basilar artery curvature and peri-vertebrobasilar junctional infarcts.J Neurol Neurosurg Psychiatry(2009)80(10):1087-9210.1136/jnnp.2008.169805.
[9]Perren F,Poglia D,Landis T,Sztajzel R.Vertebral artery hypoplasia a predisposing factor for posterior circulation stroke?Neurology(2007)68(1):65-710.1212/01.wnl.0000250258.76706.98.
[10]Watanabe M,Takahashi A,Hashizume Y,Motegi Y,Furuse K.The correlation between vertebral artery asymmetry and pontine infarction-an MR angiography study.Rinsho Shinkeigaku(1992)32(7):708.
[11]Wolters FJ,Rinkel GJ,Vergouwen MD.Clinical course and treatment of vertebrobasilar dolichoectasia:a systematic review of the literature.Neurol Res(2015)35(2):131-710.1179/1743132812Y.0000000149.
[12]Markus HS,van der Worp HB,Rothwell PM.Posterior circulation ischaemic stroke and transient ischaemic attack:diagnosis,investigation,and secondary prevention.Lancet Neurol(2016)12(10):989-9810.1016/S1474-4422(13)70211-4.
[13]Al-Ali F,Barrow T,Duan L,Jefferson A,Louis S,Luke K,et al.Vertebral artery ostium atherosclerotic plaque as a potential source of posterior circulation ischemic stroke result from Borgess Medical Center vertebral artery ostium stenting registry.Stroke(2015)42(9):2544-910.1161/STROKEAHA.110.610451.
[14]Qureshi AI,Caplan LR.Intracranial atherosclerosis.Lancet(2016)383(9921):984-9810.1016/S0140-6736(13)61088-0.
[15]Caplan LR,Wityk RJ,Glass TA,Tapia J,Pazdera L,Chang HM,et al.New England Medical Center posterior circulation registry.Ann Neurol(2004)56(3):389-9810.1002/ana.20204.
[16]Schievink WI.Spontaneous dissection of the carotid and vertebral arteries.N Engl J Med(2001)344(12):898-90610.1056/NEJM200103223441206.
[17]Arnold M,Bousser MG,Fahrni G,Fischer U,Georgiadis D,Gandjour J,et al.Vertebral artery dissection presenting findings and predictors of outcome.Stroke(2006)37(10):2499-50310.1161/01.STR.0000240493.88473.39.
[18]Ramgren B,Cronqvist M,Romner B,Brandt L,Holt a s S,Larsson EM.Vertebrobasilar dissection with subarachnoid hemorrhage:a retrospective study of 29 patients.Neuroradiology(2005)47(2):97-10410.1007/s00234-005-1346-z.
[19]中国后循环缺血的专家共识,中华内科杂志Chin J Intern Med,September 2006,Vol45,No 9.
[20]Savitz SI,Caplan LR.Vertebrobasilar disease.N Engl J Med(2005)352(25):2618-2610.1056/NEJMra041544.
[21]Chimowitz MI,Lynn MJ,Derdeyn CP,Turan TN,Fiorella D,Lane BF,et al.SAMMPRIS trial investigators.Stenting versus aggressive medical therapy for intracranial arterial stenosis.NEngl J Med(2011)365(11):993-100310.1056/NEJ-Moa1105335.
[22]Furie KL,Goldstein LB,Albers GW,Khatri P,Neyens R,Turakhia MP,et al.Oral antithrombotic agents for the prevention of stroke in nonvalvular atrial fibrillation a science advisory for healthcare professionals from the American Heart Association/American Stroke Association.Stroke(2015)43(12):3442-5310.1161/STR.0b013e318266722.
[23]Engelter ST,Brandt T,Debette S,Caso V,Lichy C,Pezzini A,et al.Antiplatelets versus anticoagulation in cervical artery dissection.Stroke(2007)38(9):2605-1110.1161/STROKEAHA.107.489666.
[24]Cohen R.Surgical treatment of intracranial artery dissections.NEngl J Med(2015)125(12):1210-1216.926/NEJMra141253.
[25]Ahn JY,Han IB,Kim TG,Yoon PH,Lee YJ,Lee BH,et al.Endovascular treatment of intracranial vertebral artery dissections with stent placement or stent-assisted coiling.AJNRAm J Neuroradiol(2006)27(7):1514-20.
[26]Pfefferkorn T,Eppinger U,Linn J,Birnbaum T,Herzog J,Straube A,et al.Long-term outcome after suboccipital decompressive craniectomy for malignant cerebellar infarction.Stroke(2009)40(9):3045-5010.1161/STROKEAHA.109.550871.
[27]Sadoughi A,Rybinnik I,Cohen R.Measurement and management of increased intracranial pressure.Open Crit Care Med J(2017)6(1):56-6510.2174/1874828701306010056.
[28]Tsitsopoulos PP,Tobieson L,Enblad P,Marklund N.Surgical treatment of patients with unilateral cerebellar infarcts:clinical outcome and prognostic factors.Acta Neurochir(2015)153(10):2075-8310.1007/s00701-011-1120-4.
[29]Mostofi K.Neurosurgical management of massive cerebellar infarct outcome in 53 patients.Surg Neurol Int(2016)410.4103/2152-7806.107906.
[30]Sato S,Toyoda K,Uehara T,Toratani N,Yokota C,Moriwaki H,et al.Baseline NIH Stroke Scale Score predicting outcome in anterior and posterior circulation strokes.Neurology(2018)70(24 Pt 2):2371-710.1212/01.wnl.0000304346.14354.0b
[31]NINDS X.The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group.Tissue plasminogen activator for acute ischemic stroke.N Engl J Med(1995)333(24):1581-7.
[32]Miyagi T,Koga M,Shiokawa Y,Nakagawara J,Hasegawa Y,Furui E,et al.Intravenous alteplase at 0.6 mg/kg for acute stroke patients with basilar artery occlusion:the stroke acute management with urgent risk factor assessment and improvement(SAMURAI)recombinant tissue plasminogen activator registry.J Stroke Cerebrovasc Dis(2013)22(7):1098-10610.1016/j.jstrokecerebrovasdis.2012.08.013.
[33]王桂芳,杜景卫,孙秀娟,等.静脉溶栓桥接Solitaire支架取栓治疗急性后循环梗死并文献复习[J].中华诊断学电子杂志,Chin J Diagnostics(Electronic Edition),2018,6(2):129-133.
[34]Hacke W,Zeumer H,Ferbert A,Brückmann H,del Zoppo GJ.Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease.Stroke(1988)19(10):1216-2210.1161/01.STR.19.10.1216.
[35]Schonewille WJ,Wijman CA,Michel P,Rueckert CM,Weimar C,Mattle HP,et al.Treatment and outcomes of acute basilar artery occlusion in the Basilar Artery International Cooperation Study(BASICS):a prospective registry study.Lancet Neurol(2009)8(8):724-3010.1016/S1474-4422(09)70173-5.
[36]Jauch EC,Saver JL,Adams HP,Bruno A,Demaerschalk BM,Khatri P,et al.Guidelines for the early management of patients with acute ischemic stroke a guideline for healthcare professionals from the American Heart Association/American Stroke Association.Stroke(2016)44(3):870-94710.1161/STR.0b013e318284056a.
[37]吴文琴,皮海菊,秦雪琴,等.动脉溶栓术治疗后循环急性脑梗死的短期疗效及对预后的影响志[J].中西医结合心脑血管病杂志,2018,16(16):1913-1915.
[38]Smith WS,Sung G,Saver J,Budzik R,Duckwiler G,Liebeskind DS,et al.Mechanical thrombectomy for acute ischemic stroke final results of the multi MERCI trial.Stroke(2008)39(4):1205-1210.1161/STROKEAHA.107.497115.
[39]Langer D,Alexander M,Janardhan V,Hartmann M,Jansen O,Sit SP,et al.The penumbra pivotal stroke trial safety and effectiveness of a new generation of mechanical devices for clot removal in intracranial large vessel occlusive disease.Stroke(2017)40(8):2761-810.1161/STROKEAHA.108.544957.
[40]Searls DE,Pazdera L,Korbel E,Vysata O,Caplan LR.Symptoms and signs of posterior circulation ischemia in the new England Medical Center posterior circulation registry.Arch Neurol(20162)69(3):346-5110.1001/archneurol.2011.2083.
[41]Akhtar N,Kamran SI,Deleu D,D’Souza A,Miyares F,Elsotouhy A,et al.Ischaemic posterior circulation stroke in State of Qatar.Eur J Neurol(2012)16:1004-910.1111/j.1468-1331.2009.02709.x
[42]陈玉辉,王音,徐蕾,等.后循环脑梗死的临床特点及相关危险因素分析[J].中国心血管杂志,2014,19(2):101-104.
[43]闫振国,王长德,童舒雯,等.后循环缺血单发性眩晕中医药治疗进展[J].中医药导报,2018,24(8):85-87.
[44]周艳红,纪春玲.中医治疗后循环缺血性眩晕[J].中国医药指南,2015,13(32):193-194.
[45]王烁,刘金民.祛风化痰法治疗后循环短暂缺血发作所致急性眩晕疗效观察[J].中国中医急症,2010,19(12):2025-2028.
[46]周道友三七通舒胶囊治疗后循环缺血患者的疗效及其对血压及内皮素的影响[J].南方医科大学学报,2010,30(2):397-400.
[47]袁志俊,李小刚,何晓英,等.天舒片治疗后循环缺血合并高血压患者的临床疗效及其对内皮细胞膜微粒表达的影响[J].实用心脑肺血管病杂志,2018,26(2):84-87.
[48]张海燕,肖洪波,朱庆军.针刺三重穴加放血疗法治疗后循环缺血性眩晕临床观察[J].安徽中医药大学学报,2017,36(6):50-53.
[49]丁明俊,蔡圣朝,楚二星.百会实按灸结合针刺治疗后循环缺血性眩晕临床疗效观察[J].中医药临床杂志,2015,27(1):53-55.
[50]陈文生,王玉龙,李华.早期康复训练对后循环脑梗死吞咽困难患者吸入性肺炎的影响[J].中国实用医药,2018,13(19):144-146.
[2]Labropoulos N,Nandivada P,Bekelis K.Stroke of the posterior cerebral circulation.Int Angiol(2014)30(2):105-14.
[3]Gao LY,Guo X,Zhou JJ,Zhang Q,Fu J,Chen WJ,et al.Basilar artery fenestration detected with CT angiography.Eur Radiol(2015)23(10):2861-710.1007/s00330-013-2890-2.
[4]Griessenauer CJ,Loukas M,Tubbs RS,Cohen-Gadol AA.The artery of Percheron:an anatomic study with potential neurosurgical and neuroendovascular importance.Br J Neurosurg(2016)28(1):81-510.3109/02688697.2013.812181.
[5]Lazzaro NA,Wright B,Castillo M,Fischbein NJ,Glastonbury CM,Hildenbrand PG,et al.Artery of Percheron infarction:imaging patterns and clinical spectrum.AJNR Am J Neuroradiol(2012)31(7):1283-910.3174/ajnr.A2044.
[6]Forster A,Nolte I,Wenz H,Al-Zghloul M,Kerl HU,Brockmann MA,et al.Anatomical variations in the posterior part of the circle of Willis and vascular pathology in bilateral thalamic infarction.J Neuroimaging(2015).10.1111/jon.12022.
[7]Miralles M,Dolz JL,Cotillas J,Aldoma J,Santiso MA,Giménez A,et al.The role of the circle of Willis in carotid occlusion:assessment with phase contrast MR angiography and transcranial duplex.Eur J Vasc Endovasc Surg(1995)10(4):424-3010.1016/S1078-5884(05)80164-9.
[8]Hong JM,Chung CS,Bang OY,Yong SW,Joo IS,Huh K.Vertebral artery dominance contributes to basilar artery curvature and peri-vertebrobasilar junctional infarcts.J Neurol Neurosurg Psychiatry(2009)80(10):1087-9210.1136/jnnp.2008.169805.
[9]Perren F,Poglia D,Landis T,Sztajzel R.Vertebral artery hypoplasia a predisposing factor for posterior circulation stroke?Neurology(2007)68(1):65-710.1212/01.wnl.0000250258.76706.98.
[10]Watanabe M,Takahashi A,Hashizume Y,Motegi Y,Furuse K.The correlation between vertebral artery asymmetry and pontine infarction-an MR angiography study.Rinsho Shinkeigaku(1992)32(7):708.
[11]Wolters FJ,Rinkel GJ,Vergouwen MD.Clinical course and treatment of vertebrobasilar dolichoectasia:a systematic review of the literature.Neurol Res(2015)35(2):131-710.1179/1743132812Y.0000000149.
[12]Markus HS,van der Worp HB,Rothwell PM.Posterior circulation ischaemic stroke and transient ischaemic attack:diagnosis,investigation,and secondary prevention.Lancet Neurol(2016)12(10):989-9810.1016/S1474-4422(13)70211-4.
[13]Al-Ali F,Barrow T,Duan L,Jefferson A,Louis S,Luke K,et al.Vertebral artery ostium atherosclerotic plaque as a potential source of posterior circulation ischemic stroke result from Borgess Medical Center vertebral artery ostium stenting registry.Stroke(2015)42(9):2544-910.1161/STROKEAHA.110.610451.
[14]Qureshi AI,Caplan LR.Intracranial atherosclerosis.Lancet(2016)383(9921):984-9810.1016/S0140-6736(13)61088-0.
[15]Caplan LR,Wityk RJ,Glass TA,Tapia J,Pazdera L,Chang HM,et al.New England Medical Center posterior circulation registry.Ann Neurol(2004)56(3):389-9810.1002/ana.20204.
[16]Schievink WI.Spontaneous dissection of the carotid and vertebral arteries.N Engl J Med(2001)344(12):898-90610.1056/NEJM200103223441206.
[17]Arnold M,Bousser MG,Fahrni G,Fischer U,Georgiadis D,Gandjour J,et al.Vertebral artery dissection presenting findings and predictors of outcome.Stroke(2006)37(10):2499-50310.1161/01.STR.0000240493.88473.39.
[18]Ramgren B,Cronqvist M,Romner B,Brandt L,Holt a s S,Larsson EM.Vertebrobasilar dissection with subarachnoid hemorrhage:a retrospective study of 29 patients.Neuroradiology(2005)47(2):97-10410.1007/s00234-005-1346-z.
[19]中国后循环缺血的专家共识,中华内科杂志Chin J Intern Med,September 2006,Vol45,No 9.
[20]Savitz SI,Caplan LR.Vertebrobasilar disease.N Engl J Med(2005)352(25):2618-2610.1056/NEJMra041544.
[21]Chimowitz MI,Lynn MJ,Derdeyn CP,Turan TN,Fiorella D,Lane BF,et al.SAMMPRIS trial investigators.Stenting versus aggressive medical therapy for intracranial arterial stenosis.NEngl J Med(2011)365(11):993-100310.1056/NEJ-Moa1105335.
[22]Furie KL,Goldstein LB,Albers GW,Khatri P,Neyens R,Turakhia MP,et al.Oral antithrombotic agents for the prevention of stroke in nonvalvular atrial fibrillation a science advisory for healthcare professionals from the American Heart Association/American Stroke Association.Stroke(2015)43(12):3442-5310.1161/STR.0b013e318266722.
[23]Engelter ST,Brandt T,Debette S,Caso V,Lichy C,Pezzini A,et al.Antiplatelets versus anticoagulation in cervical artery dissection.Stroke(2007)38(9):2605-1110.1161/STROKEAHA.107.489666.
[24]Cohen R.Surgical treatment of intracranial artery dissections.NEngl J Med(2015)125(12):1210-1216.926/NEJMra141253.
[25]Ahn JY,Han IB,Kim TG,Yoon PH,Lee YJ,Lee BH,et al.Endovascular treatment of intracranial vertebral artery dissections with stent placement or stent-assisted coiling.AJNRAm J Neuroradiol(2006)27(7):1514-20.
[26]Pfefferkorn T,Eppinger U,Linn J,Birnbaum T,Herzog J,Straube A,et al.Long-term outcome after suboccipital decompressive craniectomy for malignant cerebellar infarction.Stroke(2009)40(9):3045-5010.1161/STROKEAHA.109.550871.
[27]Sadoughi A,Rybinnik I,Cohen R.Measurement and management of increased intracranial pressure.Open Crit Care Med J(2017)6(1):56-6510.2174/1874828701306010056.
[28]Tsitsopoulos PP,Tobieson L,Enblad P,Marklund N.Surgical treatment of patients with unilateral cerebellar infarcts:clinical outcome and prognostic factors.Acta Neurochir(2015)153(10):2075-8310.1007/s00701-011-1120-4.
[29]Mostofi K.Neurosurgical management of massive cerebellar infarct outcome in 53 patients.Surg Neurol Int(2016)410.4103/2152-7806.107906.
[30]Sato S,Toyoda K,Uehara T,Toratani N,Yokota C,Moriwaki H,et al.Baseline NIH Stroke Scale Score predicting outcome in anterior and posterior circulation strokes.Neurology(2018)70(24 Pt 2):2371-710.1212/01.wnl.0000304346.14354.0b
[31]NINDS X.The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group.Tissue plasminogen activator for acute ischemic stroke.N Engl J Med(1995)333(24):1581-7.
[32]Miyagi T,Koga M,Shiokawa Y,Nakagawara J,Hasegawa Y,Furui E,et al.Intravenous alteplase at 0.6 mg/kg for acute stroke patients with basilar artery occlusion:the stroke acute management with urgent risk factor assessment and improvement(SAMURAI)recombinant tissue plasminogen activator registry.J Stroke Cerebrovasc Dis(2013)22(7):1098-10610.1016/j.jstrokecerebrovasdis.2012.08.013.
[33]王桂芳,杜景卫,孙秀娟,等.静脉溶栓桥接Solitaire支架取栓治疗急性后循环梗死并文献复习[J].中华诊断学电子杂志,Chin J Diagnostics(Electronic Edition),2018,6(2):129-133.
[34]Hacke W,Zeumer H,Ferbert A,Brückmann H,del Zoppo GJ.Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease.Stroke(1988)19(10):1216-2210.1161/01.STR.19.10.1216.
[35]Schonewille WJ,Wijman CA,Michel P,Rueckert CM,Weimar C,Mattle HP,et al.Treatment and outcomes of acute basilar artery occlusion in the Basilar Artery International Cooperation Study(BASICS):a prospective registry study.Lancet Neurol(2009)8(8):724-3010.1016/S1474-4422(09)70173-5.
[36]Jauch EC,Saver JL,Adams HP,Bruno A,Demaerschalk BM,Khatri P,et al.Guidelines for the early management of patients with acute ischemic stroke a guideline for healthcare professionals from the American Heart Association/American Stroke Association.Stroke(2016)44(3):870-94710.1161/STR.0b013e318284056a.
[37]吴文琴,皮海菊,秦雪琴,等.动脉溶栓术治疗后循环急性脑梗死的短期疗效及对预后的影响志[J].中西医结合心脑血管病杂志,2018,16(16):1913-1915.
[38]Smith WS,Sung G,Saver J,Budzik R,Duckwiler G,Liebeskind DS,et al.Mechanical thrombectomy for acute ischemic stroke final results of the multi MERCI trial.Stroke(2008)39(4):1205-1210.1161/STROKEAHA.107.497115.
[39]Langer D,Alexander M,Janardhan V,Hartmann M,Jansen O,Sit SP,et al.The penumbra pivotal stroke trial safety and effectiveness of a new generation of mechanical devices for clot removal in intracranial large vessel occlusive disease.Stroke(2017)40(8):2761-810.1161/STROKEAHA.108.544957.
[40]Searls DE,Pazdera L,Korbel E,Vysata O,Caplan LR.Symptoms and signs of posterior circulation ischemia in the new England Medical Center posterior circulation registry.Arch Neurol(20162)69(3):346-5110.1001/archneurol.2011.2083.
[41]Akhtar N,Kamran SI,Deleu D,D’Souza A,Miyares F,Elsotouhy A,et al.Ischaemic posterior circulation stroke in State of Qatar.Eur J Neurol(2012)16:1004-910.1111/j.1468-1331.2009.02709.x
[42]陈玉辉,王音,徐蕾,等.后循环脑梗死的临床特点及相关危险因素分析[J].中国心血管杂志,2014,19(2):101-104.
[43]闫振国,王长德,童舒雯,等.后循环缺血单发性眩晕中医药治疗进展[J].中医药导报,2018,24(8):85-87.
[44]周艳红,纪春玲.中医治疗后循环缺血性眩晕[J].中国医药指南,2015,13(32):193-194.
[45]王烁,刘金民.祛风化痰法治疗后循环短暂缺血发作所致急性眩晕疗效观察[J].中国中医急症,2010,19(12):2025-2028.
[46]周道友三七通舒胶囊治疗后循环缺血患者的疗效及其对血压及内皮素的影响[J].南方医科大学学报,2010,30(2):397-400.
[47]袁志俊,李小刚,何晓英,等.天舒片治疗后循环缺血合并高血压患者的临床疗效及其对内皮细胞膜微粒表达的影响[J].实用心脑肺血管病杂志,2018,26(2):84-87.
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