标题：肢体抖动性短暂性脑缺血发作10例临床分析

      作者：李其富 1，郑洪波 2，容琼文 1，王 埮 1，王淑荣 1，陈志斌 1*
    (1.海南医学院附属医院神经内科，海南 海口 570102；
2.四川大学华西医院神经内科，四川 成都 610041)

      卷次： 2012年23卷15期

      【摘要】 目的 研究肢体抖动性短暂性脑缺血发作(Limb-shaking transient ischemic attacks，LS-TIA)的临床
特点和预后。方法 2009年7月至2010年12月两家三甲医院前瞻性卒中登记库中连续性LS-TIA的患者，研究其
TIA特点、头颅影像学表现，并予以药物和/或支架置入治疗，随访1年时用改良的Rankin评分(mRS)。结果 共纳
入10例LS-TIA患者，多于活动时诱发(7例)，以下肢抖动(8例)伴无力(7例)为主要表现，持续时间<5 min，颈内动
脉重度狭窄(7例)和大脑中动脉狭窄(3例)，MRI仅2例显示分水岭脑梗死，8例示腔隙性脑梗死，4例颈动脉颅外
段狭窄经过药物联合支架治疗，5例颅内血管狭窄经过强化药物治疗随访1年mRS为0分，1例颈动脉起始段重
度狭窄单纯药物治疗，1个月后发生同侧脑梗死，1年后mRS为4分。结论 对于MRI仅显示腔隙性脑梗死的肢
体抖动患者需警惕为LS-TIA，对颅外颈动脉狭窄的LS-TIA支架置入治疗和颅内动脉狭窄的LS-TIA采取积极的
药物具有较好的预后。

      【关键词】 肢体抖动性短暂性脑缺血发作；磁共振成像；支架置入术

      【中图分类号】 R743.31 【文献标识码】 A 【文章编号】 1003—6350（2012）15—009—03<

br>Clinical analysis on 10 cases of limb-shaking transient ischemic attacks.
LI Qi-fu 1, ZHENG Hong-bo 2, RONG
Qiong-wen 1, WANG Tan 1, WANG Shu-rong 1, CHEN Zhi-bin 1. 1.Department of Neurology, the Affiliated Hospital of
Hainan Medical College, Haikou 570102, CHINA; 2. Department of Neurology, West China Hospital, Sichuan University,
Chengdu 610041, Sichuan, CHINA

【Abstract】 Objective To explore the clinical features and prognosis of the limb-shaking transient ischemic
attacks (LS-TIA). Methods Ten patients with LS-TIA in two third-grade A-level hospitals from Jul. 2009 to Dec.
2010 were studied for their TIA characteristics and cranial imaging. The patients were treated with antiplatelet drugs
and/or interventional therapies, and followed up for 1 year. Modified Rankin Scale (mRS) was used to evaluate the
clinical efficacy. Results Of the 10 patients, 7 were induced by activity. Eight of the patients had the lower limbs
shaking with duration of less than 5 minutes and 7 had concomitant weakness. Seven patients were found with internal
carotid artery severe stenosis and 3 with middle cerebral artery stenosis. Two cases of cranial MRI revealed watershed
infarction and the remaining 8 cases showed lacunar infarction lesions. Four patients with extracranial carotid severe
stenosis were given antiplatelet, statins drugs and carotid artery stenting, and 5 patients of intracranial vascular steno-
sis were administered aggressive drugs including two antiplatelet and statins drugs. The above 9 patients were fol-
lowed up for 1 year and the mRS were 0. One case with the severe stenosis of carotid artery was only given drugs and
islateral ischemic stroke occurred after 1 month, with mRS of 4. Conclusion The patients with limb shaking and
with MRI showing lacunar infarction lesion need to be alert for LS-TIA. Stenting for extracranial carotid stenosis and
aggressive drugs for intracranial arteries stenosis may reach better long-term outcomes.

      【Key words】 Limb shaking transient ischemic attack; Magnetic resonance imaging; Stenting
·论 著·