Thakur Kiran Teresa, Westover M Brandon
Massachusetts General Hospital, Department of Neurology, Boston, Massachusetts, United States.
BMJ Case Rep. 2011 Oct 28;2011:bcr0820114714. doi: 10.1136/bcr.08.2011.4714.
A 65-year-old man presented with fluctuating focal neurological deficits and neuroimaging findings of multiple small cerebral infarctions. His medical investigation revealed a >100 pack/year smoking history, and a haematocrit >60. Subsequent investigations led to a diagnosis of cerebral infarction due to smoker's polycythemia, the third such case reported in the medical literature. The patient's neurological deficits resolved completely with subsequent haematocrit reduction. This brief report reviews the differential diagnosis of polycythemia, current knowledge of the mechanisms by which smoker's polycythemia may lead to ischemic stroke, and recommendations for management.
一名65岁男性出现波动性局灶性神经功能缺损及多发性小脑梗死的神经影像学表现。他的医学检查显示有超过100包/年的吸烟史,且血细胞比容>60。后续检查诊断为因吸烟者红细胞增多症导致的脑梗死,这是医学文献中报道的第三例此类病例。随着血细胞比容随后降低,患者的神经功能缺损完全缓解。本简短报告回顾了红细胞增多症的鉴别诊断、吸烟者红细胞增多症可能导致缺血性卒中的机制的现有知识以及管理建议。