Nedelmann Max, Kolbe Maren, Angermueller Daniel, Franzen Wolfgang, Gizewski Elke R
Department of Neurology, Justus Liebig University Giessen, Giessen, Germany.
Case Rep Neurol. 2011 Apr 20;3(1):97-102. doi: 10.1159/000327683.
Limb-shaking transient ischemic attacks (TIA) may occur in patients with insufficient brain perfusion due to an underlying occlusive disease. We present the case of a 64-year-old patient who suffered from repetitive TIA presenting with shaking movements of the right-sided extremities and accompanying speech arrest. Symptoms are documented in the online supplementary video (www.karger.com/doi/10.1159/000327683). These episodes were frequently triggered in orthostatic situations. The diagnosis of limb-shaking TIA was established. The diagnostic workup revealed pseudo-occlusion of the left internal carotid artery, a poor intracranial collateral status and, as a consequence, an exhausted vasomotor reserve capacity. At ultrasound examination, symptoms were provoked by a change of the patient's position from supine to sitting. During evolvement of symptoms, a dramatic decrease of flow velocities in the left middle cerebral artery was observed. This case thus documents the magnitude and dynamics of perfusion failure in a rare manifestation of cerebral ischemic disease.
肢体抖动性短暂性脑缺血发作（TIA）可能发生在因潜在闭塞性疾病导致脑灌注不足的患者中。我们报告一例64岁患者，其反复出现TIA，表现为右侧肢体抖动并伴有言语停顿。症状记录于在线补充视频（www.karger.com/doi/10.1159/000327683）。这些发作常在直立位时诱发。肢体抖动性TIA的诊断得以确立。诊断性检查发现左颈内动脉假性闭塞、颅内侧支循环状况不佳，结果导致血管运动储备能力耗竭。超声检查时，患者从仰卧位变为坐位可诱发症状。在症状发作过程中，观察到左大脑中动脉血流速度急剧下降。因此，该病例记录了这种罕见的脑缺血疾病表现中灌注衰竭的程度和动态变化。
