张 浩,拜承萍

基底节的解剖结构较为复杂，大脑中动脉的穿支动脉是主要的供血动脉。基底节区梗死的发病机制可由穿支动脉病变所致，目前机制仍在研究中。脑白质高信号(white matter hyperintensity,WMH)是脑小血管病的重要影像标记物之一，而且穿支动脉与小血管有更紧密的联系，WMH与穿支动脉病变引发的梗死之间的联系可能非常紧密。目前基底节区梗死与WMH之间的关系仍在研究中，现就基底节区梗死与WMH的关系作相关的综述。

基底节区梗死；脑白质高信号；穿支动脉

[1] 《中国脑卒中防治报告2021》编写组,王陇德.《中国脑卒中防治报告2021》概要[J].中国脑血管病杂志,2023,20(11):783-792. [2] Ma Q,Li R,Wang L,et al.Temporal trend and attributable risk factors of stroke burden in China,1990-2019:an analysis for the Global Burden of Disease Study 2019[J].Lancet Public Health,2021,6(12):e897‑e906. [3] Wang W,Jiang B,Sun H,et al.Prevalence,incidence,and mortality of stroke in China:results from a nationwide population‑based survey of 480 687 adults[J].Circulation,2017,135(8):759-771. [4] 王维治.神经病学[M].北京:人民卫生出版社,2006:32-35. [5] Fisher C M.LACUNES:SMALL,DEEP CEREBRAL INFARCTS[J].Neurology,2011,77(24):774-784. [6] Chung J W,Kim B J,Sohn C H,et al.Branch atheromatous plaque:a major cause of lacunar infarction(high-resolution MRI study)[J].Cerebrovasc Dis Extra,2012,2(1):36-44. [7] Waterston J A,Brown M M,Butler P,et al.Small deep cerebral infarcts associated with occlusive internal carotid artery disease:A hemodynamic phenomenon?[J].Archives of Neurology,1990,47(9):953. [8] Kim J S,Nah H W,Park S M,et al.Risk factors and stroke mechanisms in atherosclerotic stroke:intracranial compared with extracranial and anterior compared with posterior circulation disease[J].Stroke,2012,43(12):3313-8. [9] 高山,王伟.大脑中动脉狭窄与其深穿支供血区单发脑梗死的关系[J].中华神经科杂志,2008,41(12):812-815. [10] Wardlaw JM,Valdés Hernández MC,Muñoz-Maniega S.What are white matter hyperintensities made of?Relevance to vascular cognitive impairment[J].Journal of the American Heart Association,2015,4(6):001140. [11] Jorgensen DR,Shaaban CE,Wiley CA,et al.A population neuroscience approach to the study of cerebral small vessel disease in midlife and late life:an invited review[J].Am J Physiol Heart Circ Physiol,2018,314:H1117-H1136. [12] Debette S and Markus HS.The clinical importance of white matter hyperintensities on brain magnetic resonance imaging:systematic review and meta-analysis[J].BMJ(Clinical research ed),2010,341,c3666. [13] Shi Y and Wardlaw JM.Update on cerebral small vessel disease:a dynamic whole brain disease[J].Stroke and vascular neurology,2016,1(3):83-92. [14] 张月.高分辨磁共振成像对基底节区急性脑梗死的M1段血管斑块特征分析的应用研究[D].承德医学院,2020. [15] Arboix A,Martívilalta J L.Lacunar stroke[J].Expert Review of Neurotherapeutics,2009,9(2):179-196. [16] Fisher C M.Lacunes:Small,Deep Cerebral Infarcts[J].Neurology,1965,15:774-784. [17] Nakase T,Yoshioka S,Sasaki M,et al.Clinical evaluation of lacunar infarction and branch atheromatous disease[J].Journal of Stroke.Cerebrovascular Diseases the Official Journal of National Stroke Association,2013,22(4):406. [18] Caplan L R.Intracranial branch atheromatous disease:a neglected,understudied,and underused concept[J].Neurology,1989,39(9):1246-1250. [19] Kwan M W,Mak W,Cheung R T,et al.Ischemic stroke related to intracranial branch atheromatous disease and comparison with large and small artery diseases[J].J Neurol Sci,2011,303(1-2):80-84. [20] Duering M,Biessels GJ,Brodtmann A,et al.Neuroimaging standards for research into small vessel disease-advances since 2013[J].Lancet Neurol.2023 Jul;22(7):602-618. [21] De Kort FAS,Coenen M,Weaver NA,et a1.White matter hyperintensity volume and poststIuke cognition:an individual patient data pooled analysis of 9 ischemic stroke cohort studies[J].Stroke,2023,54(12):3021—3029. [22] Clancy U,Gilmartin D,Jochems ACC,et al.Neuropsychiatric symptoms associated with cerebral small vessel disease:a systematic review and Meta-analysis[J].Lancet Psychiatry,2021,8(3):225-236. [23] Bonkhoff AK,Hong S,Bretzner M,et al.Association of stroke lesion pattern and white matter hyperintensity burden with stroke severity and outcome[J].Neurology,2022,99(13):e1364-e1379. [24] 叶瑾怡,王赞,龚宇田,等.脑小血管病研究的神经影像学标准STRIVE-2-自2013年以来的新进展[J].中国卒中杂志,2023,18(10):1160-1174. [25] de Leeuw FE,de Groot JC,Achten E,et al.Prevalence of cerebral white matter lesions in elderly people:a population based magnetic resonance imaging study.The Rotterdam scan study[J].Neurol Neurosurg Psychiatry,2001,70(1):9-14. [26] Hiremath,N.,Kate,M.,Mohimen,A.,et al.(2020)Risk Factors of White Matter Hyperintensities in South Asian Patients with Transient Ischemic Attack and Minor Stroke[J].Neuroradiology,62,1279-1284. [37] LIN Q,HUANG W Q,MA Q L,et al.Incidence and risk factors of leukoaraiosis from 4683 hospitalized patients:across-sectional study[J/OL].Medicine(Baltimore),2017,96(39):e7682. [28] Jochems ACC,Arteaga C,Chappell F,et al.Longitudinal Changes of White Matter Hyperintensities in Sporadic Small Vessel Disease:A Systematic Review and Meta-analysis[J].Neurology.2022 Nov 29;99(22):e2454-e2463. [29] Iordanishvili,E.,Schall,M.,Loução,R.et al.Quantitative MRI of cerebral white matter hyperintensities:A new approach towards understanding the underlying pathology[J].Neuroimage.2019 Nov 15;202:116077. [30] Swardfager W,Yu D,Ramirez J.et al.Peripheral inflammatory markers indicate microstructural damage within periventricular white matter hyperintensities in Alzheimer's disease:A preliminary report[J].Alzheimers Dement(Amst).2017 Jan 21;7:56-60. [31] Lin J,Wang D,Lan L.et al.Multiple Factors Involved in the Pathogenesis of White Matter Lesions[J].Biomed Res Int.2017;2017:9372050. [32] 周西瑞,喻志源,骆翔.脑白质高信号的研究进展[J].神经损伤与功能重建,2020,15(8):464-465+468. [33] Vuorinen M,Spulber G,Damangir S,et al.Midlife CAIDE dementia risk score and dementia-related brain changes up to 30 years later on magnetic resonance imaging[J].J Alzheimers Dis,2015,44:93-101. [34] Swan GE,DeCarli C,Miller BL,et al.Association of midlife blood pressure to late-life cognitive decline and brain morphology[J].Neur- ology,1998,51:986-993. [35] Park K,Nemoto K,Yamakawa Y,et al.Cerebral White Matter Hyperintensity as a Healthcare Quotient[J].J Clin Med,2019,8:1823. [36] Yang L,Qin W,Zhang X Y,et al.Infarct Size May Distinguish the Pathogenesis of Lacunar Infarction of the Middle Cerebral Artery Territory[J].Med Sci Monitor,2016,22:211-218. [37] Shi Y,Wardlaw J M.Update on cerebral small vessel disease:a dynamic whole-brain disease[J].Stroke Vasc Neurol,2016,1(3):83-92. [38] Ghaznawi R,Geerlings MI,Jaarsma-Coes MG,et al.The association between lacunes and white matter hyperintensity features on MRI:the SMART-MR study[J].J Cereb Blood Flow Metab,2019,39:2486-2496.

点击下载PDF