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中华脑血管病杂志(电子版) ›› 2022, Vol. 16 ›› Issue (02) : 134 -137. doi: 10.11817/j.issn.1673-9248.2022.02.014

所属专题: 经典病例

病例报告

肿瘤相关非细菌性血栓性心内膜炎致脑栓塞一例
朱小倩1, 仝莹1, 梁冬忆1, 李菲菲1, 马冬璞1,()   
  1. 1. 450000 郑州,郑州大学附属郑州中心医院神经重症科
  • 收稿日期:2022-02-25 出版日期:2022-04-01
  • 通信作者: 马冬璞
  • 基金资助:
    河南省医学科技攻关计划联合共建项目(LHGJ20200763)

Cerebral embolism caused by tumor-related nonbacterial thrombotic endocarditis: a case report

Xiaoqian Zhu1, Ying Tong1, Dongyi Liang1   

  • Received:2022-02-25 Published:2022-04-01
引用本文:

朱小倩, 仝莹, 梁冬忆, 李菲菲, 马冬璞. 肿瘤相关非细菌性血栓性心内膜炎致脑栓塞一例[J]. 中华脑血管病杂志(电子版), 2022, 16(02): 134-137.

Xiaoqian Zhu, Ying Tong, Dongyi Liang. Cerebral embolism caused by tumor-related nonbacterial thrombotic endocarditis: a case report[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(02): 134-137.

图2 患者入院胸部CT平扫示左肺上叶结节,纵隔多发淋巴结肿大。图a为普通扫查图像,图b为增强CT扫查图像
图3 患者术中脑血管造影图像。图a示脑血管造影前右侧颈内动脉末端闭塞;图b示脑血管造影后大脑前动脉开通,大脑中动脉闭塞;图c及图d示椎基底动脉、左侧颈内动脉造影未见异常
图4 患者术后头颅磁共振成像图像。图a、b:ADC序列可见右基底节区、额顶叶、侧脑室旁及双侧额叶呈低信号;图c、d:弥散加权成像序列可见右基底节区、额顶叶、侧脑室旁及双侧额叶呈高信号;图e、j:FLAIR序列可见右基底节区、额顶叶、侧脑室旁及双侧额叶呈高信号;图f、g:T2序列可见右基底节区、额顶叶、侧脑室旁及双侧额叶长T2信号;图h、i:T1序列可见右基底节区、额顶叶、侧脑室旁及双侧额叶长T1信号
图5 患者术后脑组织灌注评估图像。图a~d示右侧颞顶叶、基底节区及双侧侧脑室旁、左侧额叶病变区达峰时间及平均通过时间延长;图e~h示脑血流量减低,脑血容量部分减低,右侧基底节区局部无灌注区
图6 患者术后磁共振血管造影可见右侧大脑中动脉M1段闭塞
图7 冠状动脉造影术中影像。图a心脏冠状动脉造影提示左主干闭塞;图b示左主干闭塞支架置入后,2b级血流;图c示右冠状动脉显影良好
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