Sawamura Atsushi, Gando Satoshi, Mishima Tetsuya, Inoue Michio, Sasamori Yumiko, Matsumura Shigeki, Takahashi Hachisaburo
Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Japan.
No Shinkei Geka. 2010 May;38(5):463-71.
Brugada syndrome is a known cause of sudden death. We report a case of Brugada syndrome who was transferred by ambulance to our neurosurgical hospital. An 18-year-old male suddenly lost consciousness and collapsed at his home. His mother urgently called for an ambulance because there was atypical absence of consciousness for several minutes. Because the Japan Coma Scale (JCS) and the consciousness level was about 10 on arrival by ambulance, the emergency services suspected brain concussion, so transported him to our neurosurgical hospital. However, the JCS reached a level of 1 in the emergency room. Both skull X-P and a brain CT scan were performed but no abnormalities were observed, such as bone fracture or hematoma camed by cerebral contusion of the skull. We recognized a saddle-back ST elevation in the V3 portion and an atypical corved ST elevation in the V1-V2 portion based on the findings of electrocardiograms. As a result of the above findings, we suspected that the patient may have Brugada syndrome and the patient was therefore hospitalized and carefully followed up. We finally diagnosed the patient to have Brugada syndrome after consulting with a circulatory organ internal medicine specialist during the patient's hospitalization. Since, Brugada syndrome is a disease that may result in sudden death, further steps, such as an ICD (implantable cardioverter defibrillator) are thus considered to be necessary in this case.
布加综合征是已知的猝死原因。我们报告一例通过救护车转送至我院神经外科的布加综合征病例。一名18岁男性在家中突然失去意识并晕倒。因其出现数分钟的非典型意识丧失，其母亲紧急呼叫了救护车。由于到达时日本昏迷量表（JCS）评分及意识水平约为10分，急救人员怀疑为脑震荡，遂将其转送至我院神经外科。然而，在急诊室JCS评分降至1分。头颅X线平片和脑部CT扫描均进行了，但未观察到异常，如颅骨骨折或脑挫裂伤所致的血肿。根据心电图结果，我们在V3导联发现鞍背样ST段抬高，在V1-V2导联发现非典型的弯曲ST段抬高。基于上述发现，我们怀疑该患者可能患有布加综合征，因此将患者收住院并进行密切随访。在患者住院期间，经与循环系统内科专家会诊后，我们最终诊断该患者患有布加综合征。由于布加综合征是一种可能导致猝死的疾病，因此在这种情况下，考虑采取进一步措施，如植入式心律转复除颤器（ICD）是必要的。
