Shimizu Yoshiomi, Fukunaga Ryuzo, Kinoshita Makoto, Yamamoto Shiro, Kajiyama Kouji, Yamaguchi Takenori
Department of Internal Medicine, Hoshigaoka Kouseinenkin Hospital, Hirakata.
Intern Med. 2007;46(18):1609-12. doi: 10.2169/internalmedicine.46.0193. Epub 2007 Sep 14.
We report a patient who developed lacunar syndrome due to left upper pons infarction after performing leg exercises associated with paradoxical brain embolism. A 32-year-old man developed right arm weakness and moderate dysarthria following leg exercise. Brain MRI showed a paramedian pontine infarction of the left upper pons, and contrast transesophageal echocardiographic examination indicated that the patent foramen ovale was the embolic source. Simultaneous RI venography examination of the lower limbs identified deep venous thrombosis in the right leg as a paradoxical emboligenic source. We concluded that the presence of lacunar syndrome suggests that this mechanism was responsible for the paradoxical brain embolism.
我们报告了一例患者，在进行与反常脑栓塞相关的腿部锻炼后，因左脑桥上段梗死而出现腔隙综合征。一名32岁男性在腿部锻炼后出现右臂无力和中度构音障碍。脑部MRI显示左脑桥上段旁正中梗死，经食管超声心动图造影检查表明卵圆孔未闭是栓子来源。同时对下肢进行的RI静脉造影检查发现右腿深静脉血栓形成是反常栓子来源。我们得出结论，腔隙综合征的存在表明这种机制导致了反常脑栓塞。
