Kato Yuji, Dembo Tomohisa, Takeda Hidetaka, Fukuoka Takuya, Nagoya Harumitsu, Deguchi Ichiro, Maruyama Hajime, Furuya Daisuke, Tanahashi Norio
Department of Neurology and Cerebrovascular Medicine, Saitama International Medical Center, Saitama Medical University, Saitama.
Intern Med. 2010;49(7):695-9. doi: 10.2169/internalmedicine.49.3033. Epub 2010 Apr 1.
The clinical symptoms of Takayasu's arteritis (TA), which mainly affects the aorta and major aortic branches, vary widely depending on the site and degree of arterial lesions. We present herein the case of a young man whose initial symptom was pulmonary artery occlusion and who manifested TA 6 years later as cerebral embolism. Angiography confirmed bilateral common carotid artery (CCA) occlusion and a well-developed collateral circulation. The stump of the occluded CCA has both proximal and distal ends. The possibility of emboli from the occluded CCA (distal stump) seems to be the most probable explanation, as turbulent flow was detected at distal stump on color Doppler sonography. The carotid stump can be a potential source of emboli in TA as well as in atherosclerosis.
高安动脉炎(TA)主要累及主动脉及其主要分支,其临床症状因动脉病变的部位和程度不同而有很大差异。我们在此报告一例年轻男性病例,其最初症状为肺动脉闭塞,6年后出现TA并表现为脑栓塞。血管造影证实双侧颈总动脉(CCA)闭塞且侧支循环良好。闭塞的CCA残端有近端和远端。彩色多普勒超声检查发现远端残端有湍流,因此来自闭塞CCA(远端残端)的栓子可能性似乎是最合理的解释。在TA以及动脉粥样硬化中,颈动脉残端都可能是栓子的潜在来源。