在对右侧大脑中动脉区域缺血性卒中进行静脉注射重组组织型纤溶酶原激活剂治疗期间发生左侧大脑中动脉区域梗死。
A left MCA territory infarction during intravenous recombinant tissue plasminogen activator therapy for right MCA territory ischaemic stroke.
作者信息
Lai C-C, Hu C-J
机构信息
Department of Emergency Medicine, Taipei Municipal Jen-Ai Hospital, Taiwan.
出版信息
Emerg Med J. 2006 Feb;23(2):e11. doi: 10.1136/emj.2004.022681.
Abstract
An 81 year old man with a history of hypertension received intravenous recombinant tissue plasminogen activator (tPA) for right middle cerebral artery (MCA) infarction. He had not had stroke or arrhythmia previously. The initial National Institute of Health Stroke Scale (NIHSS) score was 8. However, a left MCA territory infarction developed 2 minutes after the full course of tPA therapy was completed, and 24 hours after tPA infusion, NIHSS score was 17. The subsequent magnetic resonance imaging scan confirmed an extensive left MCA territory infarction and a small right MCA territory infarction. Although the intracerebral haemorrhage after tPA therapy is relatively more common, tPA infusion may result in an ischaemic cerebral stroke in rare cases.
摘要
一名有高血压病史的81岁男性因右侧大脑中动脉（MCA）梗死接受了静脉注射重组组织型纤溶酶原激活剂（tPA）治疗。他既往无中风或心律失常病史。最初的美国国立卫生研究院卒中量表（NIHSS）评分为8分。然而，在tPA治疗全程结束后2分钟出现了左侧MCA区域梗死，tPA输注24小时后，NIHSS评分为17分。随后的磁共振成像扫描证实左侧MCA区域有广泛梗死以及右侧MCA区域有小面积梗死。虽然tPA治疗后脑出血相对更常见，但在罕见情况下，tPA输注可能导致缺血性脑卒。
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