脊髓灰质炎 (varicella zoster) 血管病变,在免疫能力强的患者中引起复发性缺血性中风
Ariana Barreau1, Jeffrey Lu2, Blake Weis3
1Carle Illinois College of Medicine, Urbana, Illinois, USA arianab@alumni.stanford.edu.
Practical neurology
|November 5, 2024
概括
脊髓灰质炎病毒血管病变会导致复发性缺血性中风,即使在健康人群中也是如此. 长时间的抗病毒和抗炎治疗可以预防新的心脏病发作,但不能消除持续的血管炎症.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 血管神经学 血管神经学
背景情况:
- 脊髓灰质炎病毒 (VZV) 感染可能导致血管病变,导致缺血性中风.
- 这一案例突出了在没有传统心血管风险因素的免疫能力强的个体中罕见的VZV血管病变的呈现.
研究的目的:
- 描述一次性缺血性中风的病例,其次是疹-疹病毒血管病变.
- 讨论VZV血管病变的诊断挑战和治疗结果.
主要方法:
- 一名66岁的妇女出现了普遍的虚弱,跌倒和认知能力下降.
- 大脑MRI揭示了急性缺血性中风,CT血管图显示左前脑和中脑动脉的显著狭窄.
- 脑脊液分析证实了VZV感染,导致诊断为VZV血管病变.
主要成果:
- 患者经历了多次缺血性中风,尽管最初的治疗是静脉注射阿西克洛维尔,普雷尼松,阿司匹林和克洛皮多格雷尔.
- 长期使用阿西克洛维尔和普雷尼松治疗可以阻止新的心脏病发作,尽管血管壁成像显示受影响动脉的持续炎症.
结论:
- 疹病毒血管病变是复发性缺血性中风的重要原因,即使在没有心血管风险因素的免疫能力强的患者中也是如此.
- 长期的抗病毒和抗炎疗法可以有效地预防新的中风,但血管壁炎症可能会持续.
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