Bugnicourt J-M, Bonnaire B, Lepage L, Garcia P-Y, Lefranc M, Godefroy O
Service de neurologie, CHU d'Amiens, 80054 Amiens cedex 1, France.
J Mal Vasc. 2008 May;33(2):106-9. doi: 10.1016/j.jmv.2008.02.004. Epub 2008 May 1.
We report a case of calcified aortic stenosis revealed by an ischemic stroke. An 81-year-old man with hyperlipidemia, hypertension and renal function impairment presented with acute onset of right-sided hemiparesis and aphasia. Head CT scan revealed a rounded calcified high-density mass within the distal segment of the left anterior cerebral artery, consistent with a calcified cerebral embolus, and an infarct in the left paracentral lobule. Transesophageal echocardiography demonstrated a sclerotic aortic valve. The patient was discharged from hospital on aspirin and atorvastatin, and the outcome was favorable. Calcified embolus remains a rare event and it has been not yet reported in the territory of anterior cerebral artery. It may be observed in aortic and mitral valve diseases, calcified plaques of the internal carotid artery and aortic arch. Renal failure promotes their development and is the cause of cardiovascular diseases. To date, aortic valve calcification is not considered as a marker of stroke risk, except when associated with severe stenosis or left ventricular hypertrophy.
我们报告一例因缺血性卒中发现的钙化性主动脉瓣狭窄病例。一名81岁男性，患有高脂血症、高血压和肾功能损害，出现急性右侧偏瘫和失语。头部CT扫描显示左大脑前动脉远端有一个圆形钙化高密度肿块，符合钙化性脑栓塞，左中央旁小叶有梗死灶。经食管超声心动图显示主动脉瓣硬化。患者出院时服用阿司匹林和阿托伐他汀，预后良好。钙化栓子仍然是一种罕见事件，尚未见在大脑前动脉供血区域的报道。它可能见于主动脉瓣和二尖瓣疾病、颈内动脉和主动脉弓的钙化斑块。肾衰竭会促进其发展，是心血管疾病的病因。迄今为止，主动脉瓣钙化除了与严重狭窄或左心室肥厚相关外，不被视为卒中风险的标志物。
