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中华脑血管病杂志(电子版) ›› 2024, Vol. 18 ›› Issue (03) : 285 -288. doi: 10.11817/j.issn.1673-9248.2024.03.016

病例报告

Opalski综合征合并小脑梗死血管内介入治疗一例
张娟利1, 何剑波1, 张恒1, 郭强1, 赵毅1, 姚力1,()   
  1. 1. 710077 陕西西安,西电集团医院神经内科
  • 收稿日期:2023-12-28 出版日期:2024-06-01
  • 通信作者: 姚力
  • 基金资助:
    陕西省自然科学基础研究计划面上项目(2024JC-YBMS-781); 环球医疗集团科研扶持基金(UM0122003)

A case of Opalski syndrome complicated with cerebellar infarction treated by endovascular intervention

Juanli Zhang, Jianbo He, Heng Zhang   

  • Received:2023-12-28 Published:2024-06-01
引用本文:

张娟利, 何剑波, 张恒, 郭强, 赵毅, 姚力. Opalski综合征合并小脑梗死血管内介入治疗一例[J]. 中华脑血管病杂志(电子版), 2024, 18(03): 285-288.

Juanli Zhang, Jianbo He, Heng Zhang. A case of Opalski syndrome complicated with cerebellar infarction treated by endovascular intervention[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(03): 285-288.

Opalski综合征是一种较为少见的特殊类型的脑干综合征,是伴有同侧肢体无力的延髓背外侧(Wallenberg)梗死的一种变异体,由法国人Opalski于1946年首次发现并命名。临床上不易识别,首诊此类患者,因患者同侧肢体偏瘫,不符合Wallenberg综合征的表现,尤其是合并其他部位梗死时,容易误诊。目前该类患者在治疗上多以内科药物保守治疗为主,血管内介入治疗较为少见。因此,为能尽早识别Opalski综合征以及尽早让患者得到有效救治,降低致残率及致死率,现将西电集团医院收治的1例合并小脑枕叶梗死的Opalski综合征病例报道如下。

图1 患者磁共振检查图像。图a~c为头颅弥散加权成像,提示左侧延髓、右侧小脑、左侧枕叶急性梗死灶。图d为头颅磁共振血管造影:基底动脉未显示。图e为颈髓磁共振成像,未见病灶
图2 患者介入手术治疗过程。图a、b双侧椎动脉造影。图c 2.0 mm×15 mm球囊由远及近进行预扩张;图d预扩张后造影;图e左椎动脉V4段置入自彭式4.0 mm×39 mm支架;图f支架植入后造影;图g支架近端未完全打开;图h串联自彭式4.0 mm×23 mm支架后造影;图i 2.5 mm×15 mm球囊后扩张;图j后扩张后造影改良脑梗死溶栓分级为3级 注:红色箭头示血管闭塞处
图3 患者3个月复查头颈部CT血管造影
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