天幕上腦中風引起之病灶同側肢體無力：二病例報告

Ipsilateral Hemiparesis Caused by Supratentorial Stroke: Two Case Reports

陳彥均(Yen-Chung Chen) ； 魏大森(Ta-Sen Wei) ； 陳致霖(Chih-Lin Chen)

《台灣復健醫學雜誌》 40卷4期 (2012/12) Pp. 239-243

https://doi.org/10.6315/2012.40(4)07

摘要

腦中風後常見之影響為病灶對側運動功能受損，致使對側肢體無力，此多為天幕上區域（supratentorial area）病灶。若是發生在天幕下區域（infratentorial area），則常可見與病灶同側之肢體無力。臨床上，我們發現兩位病人同為天幕上區域發生腦梗塞（一為復發性腦中風，在右側額葉梗塞；另一為新發生腦中風，右側視丘梗塞），但都出現與病灶同側之肢體無力，屬文獻上罕見之案例，推斷和腦中風後病灶對側大腦運動皮質重新組織，及先天未交叉錐體路徑有關。本病例報告提供二位患者臨床表現，並回顧相關文獻及進行討論，以供臨床醫師參考。

關鍵字

腦中風 ； 天幕上 ； 同側半邊無力

並列摘要

A common symptom that occurs after strokes is impaired contralesional motor function and contralateral limbs weakness. Such weakness of the limbs is often found in a supratentorial stroke. Two patients with ipsilateral limbs weakness after supratentorial stroke events were reported. One was a recurrent ischemic stroke in the right frontal lobe with right hemiparesis; the other was a new ischemic stroke in the right thalamus with right hemiparesis. There were few reported cases of ipsilateral hemiparesis caused by a supratentorial cerebral lesion. The mechanism of such symptoms may be related to 1. Activation and cortical reorganization within the motor areas of the unaffected hemisphere; and 2. Uncrossed pyramidal tract. In this report, we present clinical evidences and image data, as well as a review of associated literatures.

並列關鍵字

stroke ； supratentorial ； ipsilateral hemiparesis