进展性主动脉源性脑栓塞1例

A case of progressively aortogenous cerebral embolism

主动脉粥样硬化斑块不仅是全身性动脉粥样硬化的标志,同时也是脑栓塞重要栓子的来源。受关注相对较多的是复杂主动脉斑块(CAP),即厚度≥4 mm、存在溃疡或活动血栓的斑块。然而目前临床上对CAP相关的脑栓塞临床表现认识尚不充分。文中报道1例大型CAP导致的以反应迟钝、幻听和饮水呛咳为主要临床症状,病程形式呈阶梯样多症状叠加进展的急性主动脉源性脑栓塞患者,并结合相关文献对该例患者的影像学特点、临床表现、诊断及治疗进行分析,以利于增进临床医生对CAP相关脑栓塞的认识和诊治水平的提高。

Aortic atheroma is not only a sign of systemic atherosclerosis,but also an important embolus source of cerebral embolism.While relatively more attention is paid to complex aortic plaque(CAP),which refers to aortic plaque with a thickness of 4 mm or more,ulceration,or mobile components,clinical manifestations of CAP related cerebral embolism has not been properly investigated.This paper reports a case of aortogenous cerebral embolism attributed to CAP with the main clinical symptoms of slow response,auditory hallucination and dysphagia,and the course in the form of advancing stepwisely with multiple symptoms cumulation.The imaging characteristics,clinical manifestations,diagnosis and treatment of the patient are analyzed in combination with the literatures,through which hoping to improve the understanding,diagnosis and treatment of CAP related cerebral embolism for clinicians.