腦血栓―腦血管攝影之硏究

Cerebral Thrombosis-An Angiographic Study

蘇明勳(Ricky M. S. Su) ； 吳進安(Zin-An Wu) ； 朱復禮(Fu-Li Chu) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 3卷3期 (1978/09) Pp. 188-192

摘要

榮民總醫院自1976年1月至1977年12月兩年間神經科住院患者出院時之診斷為腦血栓(cerebral thrombosis)者共520例，其中76例(14.6%)年齡較輕或經過核子醫學檢查認為有疑問者曾施予選擇性腦血管攝影檢查。檢查結果47例(61.8%)呈血管堵塞，24例(31.6%)未見堵塞但有動脈硬化或血管腔狹窄現象，另5例(6.6%)正常。腦血栓病變發生於顱內者多於顱外，呈現血管堵塞之47例中，顱內者42例(89.4%)，顱外者5例(10.6%)，其中以中腦動脈之堵塞最多36例占76.6%。在受檢之病例中，5例接受頸動脈內膜切除(endarterectomy), 8例接受淺顳動脈與中腦動脈吻合手術(superficial temporal artery-middle cerebral artery anastomosis)以增加腦内側枝循環之效能及預防腦血之再發。
本報告以選擇病例與選擇性腦血管攝影為材料，所得之結果雖不能代表國人腦血栓病變之全盤特性，但有鑑於國內對腦血栓之探討一向採取保守態度，很少做腦血管攝影檢查，對國人腦血栓病變之特性也未能真正瞭解，因此我們提供現階段之資料藉以拋磚引玉，願大家能為此一嚴重之切身問題共同合作努力。

並列摘要

Of 520 patients of cerebral thrombosis hospitalized to the Veterans General Hospital from Jan. 1976 to Dec. 1977, 76 received selected cerebral angiography. Most of them were relatively young (average 53.9 years) and/or the brain scan showed doubtful results.
Angiographically, 47 cases (61.8%) showed complete occlusion of the cerebral artery, 24 (31.6%) atherosclerosis or diffuse arteriosclerosis and 5 (6.6%) normal. Of these 47 cases of complete cerebral arterial occlusion, 42 (89.4%) were intracranial and 5 (10.6%) extracranial. For the intracranial, occlusion of the middle cerebral artery is most common, 36 cases. Of these 24 cases of atherosclerosis or diffuse arteriosclerosis, 13 (54.2%) were intracranial, 4 (16.7%) extracranial, and remained 7 (29.2%) both intracranial and extracranial artery were involved. The, dominance of intracranial over extracranial lesion in our series is different from those reported from the Western countries, where extracranial vascular lesion is prominent.
36 of the 76 cases studied by angiography showed history of hypertension. There seems to be no correlation between hypertension and vascular lesions, either intracranial or extracranial.
Anastomosis of the superficial temporal and middle cerebral arteries was done for 8 patients with complete internal carotid or middle cerebral arterial occlusion, and endarterectomy for 5 patients with extracranial internal carotid artery atheroma.
The result from our study cannot represent a true clinical feature among Chinese patients with cerebral thrombosis, because of limited number of cases and angiographic studies were performed on selective basis. However, to our knowledge, our series is the largest in Taiwan. It is hoped that more medical specialist to participate a jointed program to study this particular disease.