Department of Internal Medicine, Santa Maria della Misericordia Hospital, Rovigo, Italy.
Neurol Sci. 2012 Apr;33(2):415-7. doi: 10.1007/s10072-011-0754-6. Epub 2011 Sep 7.
Although Broca's aphasia (BA) may mimic different neurological illness, its sudden onset often requires an emergency approach. In this paper, the management of a case of intermittent BA occurred in a young woman without history of neurological, cardiovascular and arrhythmic diseases is discussed. Diffusion-weighted magnetic resonance imaging showed two areas of hypoperfusion in the terminal branches of the left medial cerebral artery not previously diagnosed by computed tomography. Although there were no eligibility criteria for thrombolysis, patient received intravenous treatment with recombinant tissue-type plasminogen activator (rt-PA) over 1 h and at the end of rt-PA infusion aphasia completely disappeared without neurological sequelae. Transesophageal echocardiography revealed a thrombus in the left atrial appendage not previously detected by transthoracic echocardiography. In the month following the cardioembolic stroke, heart rhythm was monitored for 30 days by an external loop recorder and during this test two episodes of silent lone atrial fibrillation were collected.
虽然布罗卡失语症（BA）可能模仿不同的神经疾病，但它的突然发作通常需要紧急处理。本文讨论了一例年轻女性间歇性布罗卡失语症的病例，该患者无神经、心血管和心律失常疾病史。弥散加权磁共振成像显示左侧大脑中动脉终末支有两个区域灌注不足，而计算机断层扫描之前并未诊断出这些区域。尽管患者不符合溶栓的标准，但还是接受了静脉注射重组组织型纤溶酶原激活剂（rt-PA）治疗，超过 1 小时，在 rt-PA 输注结束时，失语症完全消失，没有神经后遗症。经食管超声心动图显示左心耳有血栓，而经胸超声心动图之前并未检测到。在心源性脑栓塞后的一个月内，使用外部环路记录器监测心律 30 天，在此期间，记录到两次无症状的孤立性心房颤动发作。
