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中华脑血管病杂志(电子版) ›› 2022, Vol. 16 ›› Issue (01) : 61 -66. doi: 10.11817/j.issn.1673-9248.2022.01.013

病例报告

脑梗死后皮质层状坏死一例
李戈1, 王志丽1, 何有娣1, 胡文立1,()   
  1. 1. 100020 首都医科大学附属北京朝阳医院神经内科
  • 收稿日期:2021-10-28 出版日期:2022-02-01
  • 通信作者: 胡文立
  • 基金资助:
    国家自然科学基金面上项目(81271309)

Cortical laminar necrosis after acute cerebral infarction: a case report

Ge Li1, Zhili Wang1, Youdi He1   

  • Received:2021-10-28 Published:2022-02-01
引用本文:

李戈, 王志丽, 何有娣, 胡文立. 脑梗死后皮质层状坏死一例[J]. 中华脑血管病杂志(电子版), 2022, 16(01): 61-66.

Ge Li, Zhili Wang, Youdi He. Cortical laminar necrosis after acute cerebral infarction: a case report[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(01): 61-66.

图1 脑梗死患者发病后首次头部CT平扫示双侧基底节区、外囊区(图a)及侧脑室旁(图b)腔隙性脑梗死
图2 脑梗死患者头部CT灌注成像示左侧大脑中动脉供血区脑血流量(图a、b)减低,脑血容量(图c、d)未见明显降低,平均通过时间(图e、f)、碘对比剂到达所有组织的时间(图g、h)延长
图3 脑梗死患者头颈部动脉三维成像显示左侧大脑中动脉M1-2段管腔重度狭窄至闭塞,颈动脉及其分支多发动脉粥样硬化改变
图4 脑梗死患者溶栓后24 h复查头部CT示左侧额叶(图a)、颞叶(图b、c)可见大片低密度影(箭头所示)
图5 脑梗死患者头部磁共振成像(发病后4 d)示左侧额叶、颞叶大片稍长T1(图a~c)、长T2(图d~f)信号,弥散加权成像(图g~i)皮层见花斑状稍高信号,表观弥散系数成像图(图j~l)皮层呈稍低信号,磁敏感加权成像见左侧顶叶(图m)、颞叶(图n)低信号。头部磁共振血管造影(图o)示脑动脉硬化改变
图6 脑梗死患者复查头部MRI(发病后9 d)示左侧额叶、颞叶大片稍长T1(图a~c)、长T2(图d~f)信号,弥散加权成像(图g~i)皮层见花斑状稍高信号,表观弥散系数成像图(图j~l)皮层呈稍低信号,磁敏感加权成像见左侧颞叶、顶叶(图m~o)呈低信号,较前增多
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