巨细胞动脉炎呈现为多重缺血性中风:内血管治疗的成功案例
Ana Órfão1, Carolina Saca2, Inês Alexandre3
1Department of Internal Medicine III, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.
European journal of case reports in internal medicine
|March 8, 2024
概括
巨细胞动脉炎 (GCA) 可以导致严重的内狭窄. 内血管治疗 (EVT) 在耐火性GCA病例中有效地预防了进一步的缺血事件,改善了患者的预后.
科学领域:
- 神经学 神经学
- 血管医学 血管医学
- 免疫学 免疫学 免疫学
背景情况:
- 巨细胞动脉炎 (GCA) 可以导致侵略性的内狭窄,导致耐火神经缺陷和脑梗塞,构成危及生命的风险.
- 对于某些GCA表现,使用皮质类固醇的医疗管理可能不足.
研究的目的:
- 报告医疗耐药的GCA病例与症状的内狭窄.
- 评估内血管治疗 (EVT) 在患有GCA和严重内狭窄症的患者的疗效.
主要方法:
- 一个68岁的女性患有GCA的病例报告.
- 最初使用普雷迪尼索隆和甲基普雷迪尼索隆脉冲治疗,后来添加托西利祖马布.
- 诊断成像包括MRI血管造影,CT血管造影,多普勒超声波和脑血管造影.
- 干预内血管治疗 (EVT) 通过气球血管塑造在内动脉 (ICAs) 上.
主要成果:
- 尽管医疗治疗,但患者呈现出全局失言症和多重缺血性病变.
- 大脑血管造影显示,内动脉的双边狭窄.
- 在EVT之后,患者表现出持续的临床改善,并在一年的随访中没有出现缺血事件的复发.
结论:
- 巨细胞动脉炎可以表现为具有攻击性和症状的内动脉狭窄症.
- 内血管治疗是预防内GCA缺血并发症的有效干预措施.
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