Lee Yeong Yeh, Bhaskar Shalini
Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150 Kota Bharu, Malaysia.
Case Rep Med. 2011;2011:271560. doi: 10.1155/2011/271560. Epub 2011 Dec 20.
We report a 33-year-old Malay woman presented with acute left dense hemiparesis and an NIHSS score of 11/15. Computed tomography (CT) scan brain showed a massive right middle cerebral artery (MCA) territory infarct. The right internal carotid artery (ICA) and right proximal MCA were shown occluded from digital substraction angiography (DSA). Carotid dissection, carotid canal anomaly, and intercavernous communication were systematically ruled out. She had no risk factors for atherosclerosis. The connective tissue screening and thrombophilic markers were negative. However, she was anaemic on admission and subsequent investigations revealed that she had alpha-thalassemia and iron deficiency anaemia. The right ICA remained occluded from a repeat CT cerebral angiogram after one year, but otherwise she was neurologically stable. This case illustrates an unusual association between intracranial vessel occlusion with iron deficiency anaemia and alpha-thalassemia trait.
我们报告了一名33岁的马来女性，她出现急性左侧严重偏瘫，美国国立卫生研究院卒中量表（NIHSS）评分为11/15。脑部计算机断层扫描（CT）显示右侧大脑中动脉（MCA）大片区域梗死。数字减影血管造影（DSA）显示右侧颈内动脉（ICA）和右侧MCA近端闭塞。系统性排除了颈动脉夹层、颈动脉管异常和海绵窦间交通。她没有动脉粥样硬化的危险因素。结缔组织筛查和血栓形成倾向标志物均为阴性。然而，她入院时贫血，后续检查发现她患有α地中海贫血和缺铁性贫血。一年后重复的脑部CT血管造影显示右侧ICA仍然闭塞，但除此之外她神经功能稳定。该病例说明了颅内血管闭塞与缺铁性贫血和α地中海贫血特征之间的一种不寻常关联。
