Senda Joe, Ito Mizuki, Atsuta Naoki, Watanabe Hirohisa, Hattori Naoki, Kawai Hiromichi, Sobue Gen
Department of Neurology, Nagoya University Graduate School of Medicine, Aichi.
Intern Med. 2010;49(18):2003-5. doi: 10.2169/internalmedicine.49.3570. Epub 2010 Sep 15.
A 21-year-old man had sudden-onset right hemiplegia and aphasia with respiratory infection. A chest X-ray disclosed consolidation in both lungs and magnetic resonance imaging showed an embolism in the left middle cerebral artery. A pelvic computed tomography scan revealed deep venous thrombus in both femoral veins. Patent foramen ovale was detected by transesophageal echocardiogram. Antibodies to M. pneumoniae were highly elevated, and hypercoagulability was subsequently detected. This case suggests that the possible pathogenic mechanism for M. pneumoniae infection-related stroke might be paradoxical brain embolism with deep venous thrombus as a consequence of the hypercoagulability related to this infection.
一名21岁男性在呼吸道感染后突然出现右侧偏瘫和失语。胸部X线显示双肺实变，磁共振成像显示左大脑中动脉栓塞。盆腔计算机断层扫描显示双侧股静脉深静脉血栓形成。经食管超声心动图检测到卵圆孔未闭。肺炎支原体抗体高度升高，随后检测到高凝状态。该病例提示，肺炎支原体感染相关卒中可能的致病机制可能是与该感染相关的高凝状态导致的深静脉血栓形成的反常脑栓塞。
