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脑部检查 – 香港微創腦及脊椎神經外科手術中心

脑中风的影像诊断

当疑似中风患者被送往公立医院救治时,当值医生会按病人情况而安排脑部的电脑断层扫描(CT SCAN) 。 CT是一个较经济的初步影像检查,但CT只能分办出患者是属于出血性中风(占30%的中风案例),不能详细确诊患者是否患上脑血管梗塞性中风(占中风案例大多数的70%)。 CT 在脑血管梗塞性中风发生的首24小时内, 影像是可以完全正常的, 在医生亦不能确诊下, 病人就因此枉枉错失了在黄金8小时 内打通脑血管, 抢救大脑细胞及完全康复的机会。然而两种中风: 出血性和脑血管梗塞性中风的治疗迫切性及方针是截然不同的。

脑梗塞性中风就是大脑或颈血管受阻塞,血液无法流通,令脑细胞功能暂时受影响, 若时间拖延了, 大脑细胞就会死亡, 神经功能亦永久受损。

脑血管梗塞性中风大致上可分为三种不同类型。

1.动脉硬化血栓性脑梗塞
 因为血管粥样硬化而使血管内侧变得狭窄,并且形成血栓,造成血管阻塞。
2.心源性脑栓塞症
 因为心房颤动等心律不整的情况恶化,使心脏里形成的血栓窜流至大脑血管中并造成阻 塞。
3.小间隙阻塞
 因为高血压或糖尿病造成的血管病变或动脉硬化,而使血管变得狭窄,并且形成血栓,造成血管阻塞。

三种类型的脑梗塞均为常见的,而且近年更变得年轻化。

在现今先进的医学理念上, 脑血管梗塞性中风已是可以完全治愈之症。但必需在黄金8小时内及早诊断出梗塞的血管部位, 再由专攻脑血管的脑神经外科医生以先进的微创内血管手术,打脑通血管,抢救大脑,令脑细胞不致坏死及减低患者永久伤残或死亡率的机会, 患者亦大有机会完全康复。

磁力共振的脑部及血管造影(MRI,MRA), 能在脑细胞缺血的头半小时内, 精准地诊断出中风位置和血管阻塞的范围, 大大提高了专攻脑血管的脑神经外科医生能在黄金8小时内, 以先进的微创内血管手术打通脑血管, 抢救大脑细胞的成功率; 病人从而有机会完全康复。

由于公立医院资源及人手有限, 未能提供24小时紧急的磁力共振脑部及血管造影术,而CT 在脑血管梗塞性中风发生的首24小时内, 影像是可以完全正常的, 病人就因此枉枉错失了在黄金8小时内打通脑血管, 抢救大脑细胞及完全康复的机会。

HKBSSP MRI Imaging
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