骨性中风与类风湿性关节炎:一种罕见的实体还是错过的诊断?
Sofia Vedor1, Sara de Carvalho1, Gonçalo Alves1
1Neuroradiology Department, Unidade Local de Saúde de São João, Porto, PRT.
Cureus
|December 23, 2024
概括
罕见的骨性中风是由影响大脑动脉的骨异常引起的,缺乏标准化的治疗. 这一案例凸显了在复发性缺血性中风中考虑骨异常的重要性,特别是在认知障碍的情况下.
科学领域:
- 神经学 神经学
- 血管神经学 血管神经学
- 类风湿病学 类风湿病学
背景情况:
- 骨或软骨异常可以从结构上引起缺血性中风,称为"骨中风".
- 这些罕见的疾病缺乏标准化的诊断和治疗方案.
- 类风湿性关节炎可能导致头骨沉积,可能导致脊椎动脉狭窄.
研究的目的:
- 为了呈现出二次性缺血性中风的案例,以骨沉诱导的脊椎动脉狭窄.
- 强调在密码性复发性缺血性中风中考虑骨异常的重要性.
- 突出认知障碍患者的诊断挑战.
主要方法:
- 一个79岁的妇女的病例报告,患有类风湿性关节炎和部沉降.
- 诊断成像包括头部计算机断层扫描 (CT) 和CT血管扫描 (CTA).
- 使用超声波测试进行大脑血流评估.
主要成果:
- 电脑扫描显示了最近在左后下脑小动脉 (PICA) 区域中发生的中风和慢性心脏病发作.
- 由于部沉积,CTA在左脊动脉 (VA) 的V3段表现出亚闭塞性狭窄.
- 超声波显示VA的V2段的流动阻力增加.
结论:
- 骨异常应被认为是缺血性中风的结构原因,特别是在反复发生的密码性事件中.
- 由于类风湿性关节炎而导致的头骨沉降进展可能导致脊椎动脉狭窄和中风.
- 早期识别和诊断至关重要,特别是在认知障碍患者中,以防止延迟治疗.
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