以急性多发性脑梗死为主要表现的特鲁索综合征3例

Three cases of Trousseau's syndrome with acute multiple cerebral infarction as the main manifestation

目的 分析以急性多发性脑梗死为主要表现的特鲁索综合征(Trousseau’s syndrome,TS)的临床及影像学特征。方法回顾分析2019年12月至2021年12月阜阳市人民医院神经内科收治的3例以急性多发性脑梗死为主要表现的TS病人的临床资料,并结合相关文献分析该病的临床和影像特征。结果 其中男1例,女2例;发病年龄范围为52~85岁;3例病人D-二聚体均明显升高;头颅MRI均显示为以“三流域征”为特点的急性多发性脑梗死;伴腹腔转移瘤1例,伴静脉系统血栓2例;1例予低分子肝素抗凝+双抗抗血小板聚集,2例予低分子肝素抗凝治疗。结论 急性多发性脑梗死是TS的一个重要表现;对于不符合血管分布的急性多发性脑梗死,病因需考虑恶性肿瘤所致高凝状态可能;D-D是诊断TS的重要线索。

Objective To analyze the clinical and imaging features ofTrousseau'ssyndromemanifested as acute multiple cerebral in⁃farction.Methods The clinical data of 3 patients with Trousseau's syndrome presenting as acute multiple cerebral infarction admitted to the Department of Neurology the People's Hospital of Fuyang from December 2019 to December 2021 were retrospectively analyzed,and the clinical and imaging characteristics of the disease were analyzed in combination with related literature.Results Of the 3 pa⁃tients,2were female and the other wasmale;The age of onset ranged from 52 to 85 years old;D-dimer level was significantly elevated in all 3 patients;cranial MRI of all of the 3 patients showed multiple cerebral infarction,1 case with abdominal metastasis;2 cases with thrombosis of the venous system;1 case received anticoagulant and antiplatelet therapy.Two patients received anticoagulation therapy oflow molecular weight heparin.Conclusions An important manifestation of Trousseau'ssyndrome is acute multiple cerebral infarc⁃tion.Hypercoagulability caused by malignant tumor should be considered as the etiology of multiple acute cerebral infarction that does not conform to vascular distribution.D-dimer is an important clue in the diagnosis of Trousseau's syndrome.