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大脑低 perfusion 相关的 Hemichorea: 一个案例报告和文献综述
Jia Shen1, Quanzeng Zhang, Fanya Sun
1Department of Neurology, Xi'an Central Hospital, Xi'an, Shaanxi, China.
Medicine
|June 9, 2025
概括
由于短暂心脏骤停而引起的罕见心脏病发作,基底质扩散权重成像 (DWI) 呈负值,突出了动态心电图监测的重要性. 及时植入心脏起器改善了结果,并防止了复发.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 医疗成像医学成像
背景情况:
- Hemichorea 是一种带有多种原因的超金字塔性疾病.
- 血管 Hemichorea 典型的结果是基底腺梗塞,在扩散加权成像 (DWI) 上明显.
- 基底腺 DWI 阴性 Hemichorea 是非常罕见的.
研究的目的:
- 报告一个独特的 Hemichorea 病例,该病例归因于基底腺中的过渡性缺血性攻击 (TIA).
- 调查无症状短暂心脏骤停作为TIA诱导的心脏病发作病因的作用.
- 为了强调对罕见呈现的 Hemichorea 的诊断方法.
主要方法:
- 一个82岁的女性呈现急性脑膜病变的案例研究.
- 使用扩散权重成像 (DWI) 和动态心电图 (ECG) 监测.
- 进行了抗血小板治疗和心脏起器植入.
主要成果:
- 扩散加权成像 (DWI) 显示在周围叶的扩散受限,但在基底腺节是负的.
- 动态心电图显示了5.6秒的短暂心脏骤停.
- 血小板炎在抗血小板治疗后24小时内消失;在2年随访期间没有复发.
结论:
- 带有负基底质DWI的急性 Hemichorea 值得考虑从短暂的心脏骤停开始的TIA.
- 基底腺对缺血/缺氧的敏感性可能会解释心脏骤停后的血脉.
- 动态心电图和心脏起器植入对于诊断和预后至关重要.
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