Bingöl A, Togay-Işikay C
Neurology, Ankara University School of Medicine, Ankara, Turkey.
Eur J Neurol. 2006 May;13(5):544-8. doi: 10.1111/j.1468-1331.2006.01286.x.
We report a series of four cases presented with transient ischemic attacks (TIA) or ischemic stroke as the predominant manifestation of neurobrucellosis (NB). Three of the patients were 20-28 years of age, and one patient was 53 years old. They all used to consume unpasteurized milk or its products. Two patients had systemic brucellosis in the past and received antibiotic treatment. Other causes of TIA including cardiac embolism, hypercoagulability, vascular malformations, systemic vasculitis, and infective endocarditis were excluded. NB was diagnosed with serological tests or cultures for Brucella in the cerebrospinal fluid. None of the patients had any further TIA after the initiation of specific treatment. NB should always be sought in young patients with TIA or ischemic stroke, especially if they have no risk factors for stroke and live in an endemic area for brucellosis, even if they do not have other systemic signs of brucellosis.
我们报告了一系列4例以短暂性脑缺血发作(TIA)或缺血性中风为神经型布鲁氏菌病(NB)主要表现的病例。其中3例患者年龄在20 - 28岁之间,1例患者为53岁。他们都曾食用过未经巴氏消毒的牛奶或其制品。2例患者过去曾患全身性布鲁氏菌病并接受过抗生素治疗。排除了TIA的其他病因,包括心脏栓塞、高凝状态、血管畸形、系统性血管炎和感染性心内膜炎。通过血清学检测或脑脊液中布鲁氏菌培养确诊为NB。开始特异性治疗后,所有患者均未再发生TIA。对于患有TIA或缺血性中风的年轻患者,尤其是那些没有中风危险因素且生活在布鲁氏菌病流行地区的患者,即使没有其他全身性布鲁氏菌病体征,也应始终考虑NB的可能。