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心脑绕道:通过圆孔 (PFO) 的悖论性败血栓塞
Carlos Fagundo1, Cooper Dodd1, Butros Bazo1
1Internal Medicine, BayCare Health System, Tampa, USA.
Cureus
|November 17, 2025
概括
这一案例突出显示了一种罕见的脑,由心脏来源的悖论性栓塞引起,特别是右心房质量和 patent foramen ovale. 涉及手术,抗生素和吸收的多式治疗导致了患者的康复.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
背景情况:
- 脑是心脏起源的悖论性败血栓塞的不常见并发症.
- 诊断可能具有挑战性,通常需要高度的临床怀疑.
研究的目的:
- 从心脏来源呈现出一个矛盾栓塞的次要脑的病例.
- 强调考虑大脑的非典型来源的重要性.
主要方法:
- 一名65岁的女性出现了精神状态变化,发作和脱节症.
- 先进的成像 (CT和MRI) 显示了右额叶大脑.
- 经食道回声心电图发现了右心房质量和形孔.
- 切割和排水产生了中型链球菌;AngioVac吸入消除了心房质量.
主要成果:
- 该患者被诊断为脑,可能是由牙科手术引起的培养负的非膜性细菌内心炎引起的.
- 一个右心房质量和圆孔的专利促进了对脑的悖论性栓塞.
- 多模式治疗,包括手术干预和向抗生素,导致症状显著改善.
结论:
- 这一案例强调了调查大脑的不寻常心脏来源的必要性,特别是在没有内心炎的情况下.
- 早期识别,先进的神经成像和多学科方法对于成功管理和最佳患者结果至关重要.
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