Hino H, Terasaki T, Hashimoto Y, Hara Y, Uchino M
Department of Strokology, Kumamoto City Hospital.
Rinsho Shinkeigaku. 1999 Jul;39(7):705-10.
A 77-year-old man with essential thrombocythemia had embolic stroke associated with mobile thoracic ascending aortic thrombus despite of receiving antiplatelet drug. He had history of toe ulcer and ileus within previous 2 years. He was diagnosed as essential thrombocythemia and received antiplatelet drug. He had consciousness disturbance and admitted to our hospital. Cerebral angiography disclosed emboli in the right middle cerebral artery (M2). Transesophageal echocardiography showed evidence of a mobile thrombus attached to the wall of the ascending aorta at the first day. The thrombus was no longer present after treatment with heparin followed by no recurrent embolic event. We prescribed hydroxyurea for essential thrombocythemia for chronic phase treatment. We consider that with essential thrombocythemia the thrombus of the ascending aorta caused the cerebral infarction. And we succeeded of the treatment of the embolic stroke and prevalence of the emboli with essential thrombocythemia.
一名77岁的原发性血小板增多症男性患者，尽管接受了抗血小板药物治疗，但仍发生了与活动的胸段升主动脉血栓相关的栓塞性中风。他在过去2年内有足趾溃疡和肠梗阻病史。他被诊断为原发性血小板增多症并接受了抗血小板药物治疗。他出现意识障碍后入住我院。脑血管造影显示右侧大脑中动脉（M2）有栓子。经食管超声心动图在第一天显示有一个活动血栓附着在升主动脉壁上。肝素治疗后血栓消失，此后未再发生栓塞事件。我们为原发性血小板增多症的慢性期治疗开了羟基脲。我们认为原发性血小板增多症患者升主动脉的血栓导致了脑梗死。并且我们成功地治疗了栓塞性中风以及原发性血小板增多症患者栓子的发生率。
