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目的观察椎基底动脉延长扩张症(VBD)与前循环障碍的关系。方法回顾性分析VBD与颈内动脉闭塞/狭窄并存病例的临床及影像学资料。结果 5例患者中,临床表现为双眼同向偏盲或视力障碍3例,一侧肢体运动障碍2例,Gerstmann综合征1例。CT/MRI显示分水岭性脑梗死(后型)2例,大脑前及大脑中动脉供血区梗死各1例,无明显改变1例;CTA/MRA显示同时伴有一侧颈内动脉闭塞3例,双侧颈动脉狭窄及发育不良(烟雾病)各1例;基底动脉长度为34.0~39.5 mm,直径为4.6~4.8 mm;颅内椎动脉最大处直径为4.4~4.8 mm。结论 VBD可与颈动脉闭塞或狭窄共存,临床表现更为复杂。长期的前循环障碍可能是VBD形成的重要促发因素,应兼顾前后循环状况制定治疗方案。
Objective To observe the relationship between vertebrobasilar prolongation (VBD) and anterior circulation disorders. Methods The clinical and imaging data of patients with VBD and internal carotid artery occlusion / stenosis were analyzed retrospectively. Results Among the 5 patients, the clinical manifestations were bilateral hemifacial blindness or visual impairment in 3 cases, unilateral limb movement disorder in 2 cases and Gerstmann’s syndrome in 1 case. CT / MRI showed two cases of watershed cerebral infarction (posterior type), one case of infarction in the anterior cerebral artery and middle cerebral artery, and no change in one case. CTA / MRA showed three cases of occlusion of the internal carotid artery in one side, Side carotid artery stenosis and hypoplasia (moyamoya disease) in 1 case. The length of the basilar artery was 34.0-39.5 mm and the diameter was 4.6-4.8 mm. The maximum diameter of the intracranial vertebral artery was 4.4-4.8 mm. Conclusions VBD can coexist with carotid artery occlusion or stenosis, and its clinical manifestations are more complicated. Long-term anterior circulation disorder may be an important trigger factor for the formation of VBD, should take into account the conditions before and after the development of treatment programs.