封堵术治疗卵圆孔未闭合并两次新发脑梗死一例

Recurrent cerebral infarction in a male with patent foramen ovale treated by interventional closure

目的探讨1例卵圆孔未闭(PFO)合并复发性隐源性卒中(CS)患者的临床、影像学特点及封堵术治疗的疗效。方法分析2018年4月11日和2018年6月1日河北医科大学第二医院神经内科收治的1例PFO合并CS患者的病例资料,并结合相关文献进行复习。结果患者37岁男性,主要临床表现为言语障碍、偏头痛、肢体无力和活动不灵活。超声心动图检查示PFO,第1次入院头颅弥散加权像(DWI)显示左侧颞枕叶急性脑梗死,第2次入院头颅DWI显示右侧小脑半球急性梗死。患者经封堵治疗后至今未再诉头痛。结论在CS患者中区分致病性PFO和非致病性PFO是必要的,PFO封堵可预防卒中复发,早期诊治能够改善患者预后。

Objective To explore the clinical,imaging features and efficacy of transcatheter closure in a recurrent cryptogenic stroke(CS)patient with patent foramen ovale(PFO).Methods The patient was admitted to the Department of Neurology of the Second Hospital of Hebei Medical University in April 11,2018 and June 1,2018.The data of the patient were analyzed.The related literatures were reviewed.Results The main clinical manifestations of the 37-year-old man were speech disorder,migraine,limb weakness and clumsiness.The echocardiography showed that the patient had PFO.The cerebral DWI of the first admission showed acute infarction of the left temporal,occipital and semicircular center.The DWI of the second admission showed that the right cerebellar hemisphere was involved.The patient has not complained of headache since the transcatheter closure.Conclusion It is necessary to distinguish non pathogenic PFO from pathogenic PFO in patients with CS.Interventional closure can prevent recurrence of stroke.So the early diagnosis and treatment can improve the patient’s prognosis.