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表现为急性卒中假象的碘甲烷中毒:一例报告

Methyl iodide poisoning presenting as a mimic of acute stroke: a case report.

作者信息

Nair Jagdish R, Chatterjee Kausik

机构信息

Department of Medicine and the Acute Stroke Unit, Countess of Chester Hospital, Chester, UK.

出版信息

J Med Case Rep. 2010 Jun 15;4:177. doi: 10.1186/1752-1947-4-177.

Abstract

INTRODUCTION

Stroke mimics are usually non-vascular disease processes. These raise the possibility of a stroke and are common in clinical practice. It is necessary to distinguish these mimics in order to provide early and appropriate management, as well as reduce possible harm on our patient.

CASE PRESENTATION

We report the case of a 50-year-old Caucasian man who developed symptoms suggestive of posterior circulation stroke after he was exposed to methyl iodide at his workplace. Results of stroke investigations of our patient were negative, and a detailed occupational history clinched the diagnosis. Acute presentation with a stroke-like picture is rare in cases of methyl iodide poisoning. We have attempted to discuss the differential diagnosis of stroke mimics through a review of literature.

CONCLUSION

Stroke mimics are difficult to diagnose in an emergency room situation and may be initially treated as stroke. This case report underlines the importance of history taking, especially occupational history, in the differential diagnosis of stroke. We also stress the need to recognize mimics at presentation in order to arrive at an early and appropriate management of patients.

摘要

引言

类卒中通常是非血管性疾病过程。这些疾病增加了发生卒中的可能性,在临床实践中很常见。为了提供早期且恰当的治疗,并减少对患者可能造成的伤害,有必要区分这些类卒中情况。

病例介绍

我们报告一例50岁的白种男性病例,该患者在工作场所接触甲基碘后出现提示后循环卒中的症状。我们患者的卒中检查结果为阴性,详细的职业史确诊了诊断。甲基碘中毒病例中急性呈现类似卒中的表现很罕见。我们试图通过文献回顾来探讨类卒中的鉴别诊断。

结论

在急诊室情况下,类卒中很难诊断,可能最初会被当作卒中治疗。本病例报告强调了病史采集,尤其是职业史,在卒中鉴别诊断中的重要性。我们还强调在就诊时识别类卒中情况对于尽早且恰当地治疗患者的必要性。

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本文引用的文献

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Interactions between migraine and stroke.偏头痛与中风的相互作用。
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TRANSIENT HYPOGLYCEMIC HEMIPLEGIA.短暂性低血糖偏瘫
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Stroke mimics and chameleons.类卒中与伪装性卒中。
Emerg Med Clin North Am. 2002 Aug;20(3):583-95. doi: 10.1016/s0733-8627(02)00012-3.

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