血栓性血小板减少性紫癜相关性脑梗死伴发脑微出血2例

Thrombotic thrombocytopenic purpura complicated with multiple cerebral infarction: report of two cases

血栓性血小板减少性紫癜(TTP)是一种少见的血液系统疾病,其典型的临床表现为血小板减少性紫癜、微血管病性溶血性贫血、神经系统症状、发热及肾脏损害。文中报道2例TTP相关性脑梗死伴发脑微出血的患者及他们共有的特殊影像学表现。2例患者磁共振成像表现出不同时期多发脑梗死,双侧半球、前后循环皆受累,而磁敏感加权成像显示分布于梗死区的脑微出血表现,这种特殊的影像学特征可为及早识别、诊断TTP神经系统受累提供重要线索。

Thrombotic thrombocytopenic purpura(TTP)is a rare hematological disease with typical clinical manifestations of thrombocytopenic purpura,microangiopathic hemolytic anemia,neurological symptoms,fever and kidney damage.Two patients with TTP-associated cerebral infarction complicated with microhemorrhage and their shared specific imaging findings manifestations were reported.The magnetic resonance imaging of the 2 patients showed multiple cerebral infarctions at different stages.Susceptibility-weighted imaging showed cerebral microbleeds in the infarcted area.This special imaging feature can provide important clues for early identification and diagnosis of TTP nervous system injury.