脑卒中后认知和情感障碍
北京大学第一医院神经内科 (100034)
卒中后，可出现偏瘫及一系列神经系统定位症状和体征，也可以发生多种大脑高级功能的障碍，如：智能和记忆障碍、失语、失认、失用、视空间障碍、忽视等认知功能障碍；并可发生焦虑、抑郁等情感障碍。这些卒中后的认知和情感障碍也同样是病人致残的原因，但未能引起大家足够的重视。上述障碍的评价与有针对性的、个体化的康复是非常重要的。
第一部分阐述了上述障碍的分类、定位或诊断标准。
第二部分报告了中国人的利手与大脑语言优势侧的关系，汉语失语症的分类、比例及与西方语言的比较。309例急性期脑卒中患者中，139例(44.98%)患有各型失语症， 其中136例(97.84%)的病灶在左侧大脑半球, 其中131例(94.24%)为右利手，5例(3.60%)为非右利手； 只有3例(2.16%)病灶在右侧大脑半球，为右利手。认为大多数中国人汉语语言中枢仍然在左侧大脑半球，汉语失语症的分类亦与西方失语症没有不同。
Cognitive disorders and mood disorders post stroke
WANG Yin-hua
Department of Neurology, First Hospital of Beijing University, Beijing 100034
【Abstract】We should pay more attention to the multiple Cognitive disorders and Mood disorders of the brain after stroke except hemiplegia, such as: Aphasia, agnosia, apracxia, visual-spatial disorder, memory disorder, vascular dementia, anxiety-depression, etc. Above higher dysfunction of the brain also can make the patients disabled and should be evaluated and then we should make out the individuation rehabilitation plan for the patients.
The first part to state the classifications, localization or criteria of above disorders.
The second part report our study about the classification, ratio, the relationship between the manuality and their linguistic cerebral dominance of Chinese aphasia and compare with the westerners. Among 309 cases with cerebral infarction and cerebral hemorrhage at their acute stage of illness, 139(44.98%) with aphasia of 10 types, of whom, 134 cases (96.40%) were dextral and 5 (3.60%) were nondextral. 136 patients (97.84%) were with aphasia due to lesions of left cerebral hemisphere, of whom, 131 cases (94.24%) were dextral and 5 (3.60%) were nondextral. Only 3 dextrals (2.16%) were with crossed aphasia due to lesions of right cerebral hemisphere. It was indicated that the mojority of the Han nationality had their linguistic cerebral dominance in left cerebral hemisphere, no matter whether they were dextral, which had no essential difference from Westerner.
【Key words】 Aphasia manuality linguistic cerebral dominant side, http://www.100md.com(王荫华)
卒中后，可出现偏瘫及一系列神经系统定位症状和体征，也可以发生多种大脑高级功能的障碍，如：智能和记忆障碍、失语、失认、失用、视空间障碍、忽视等认知功能障碍；并可发生焦虑、抑郁等情感障碍。这些卒中后的认知和情感障碍也同样是病人致残的原因，但未能引起大家足够的重视。上述障碍的评价与有针对性的、个体化的康复是非常重要的。
第一部分阐述了上述障碍的分类、定位或诊断标准。
第二部分报告了中国人的利手与大脑语言优势侧的关系，汉语失语症的分类、比例及与西方语言的比较。309例急性期脑卒中患者中，139例(44.98%)患有各型失语症， 其中136例(97.84%)的病灶在左侧大脑半球, 其中131例(94.24%)为右利手，5例(3.60%)为非右利手； 只有3例(2.16%)病灶在右侧大脑半球，为右利手。认为大多数中国人汉语语言中枢仍然在左侧大脑半球，汉语失语症的分类亦与西方失语症没有不同。
Cognitive disorders and mood disorders post stroke
WANG Yin-hua
Department of Neurology, First Hospital of Beijing University, Beijing 100034
【Abstract】We should pay more attention to the multiple Cognitive disorders and Mood disorders of the brain after stroke except hemiplegia, such as: Aphasia, agnosia, apracxia, visual-spatial disorder, memory disorder, vascular dementia, anxiety-depression, etc. Above higher dysfunction of the brain also can make the patients disabled and should be evaluated and then we should make out the individuation rehabilitation plan for the patients.
The first part to state the classifications, localization or criteria of above disorders.
The second part report our study about the classification, ratio, the relationship between the manuality and their linguistic cerebral dominance of Chinese aphasia and compare with the westerners. Among 309 cases with cerebral infarction and cerebral hemorrhage at their acute stage of illness, 139(44.98%) with aphasia of 10 types, of whom, 134 cases (96.40%) were dextral and 5 (3.60%) were nondextral. 136 patients (97.84%) were with aphasia due to lesions of left cerebral hemisphere, of whom, 131 cases (94.24%) were dextral and 5 (3.60%) were nondextral. Only 3 dextrals (2.16%) were with crossed aphasia due to lesions of right cerebral hemisphere. It was indicated that the mojority of the Han nationality had their linguistic cerebral dominance in left cerebral hemisphere, no matter whether they were dextral, which had no essential difference from Westerner.
【Key words】 Aphasia manuality linguistic cerebral dominant side, http://www.100md.com(王荫华)