Rosario Michael, Song Sarah Xianyuan, McCullough Louise D
Department of Neurology, University of Connecticut Health Center, The Stroke Center, Hartford, CT 06030, USA.
Neurologist. 2012 Jul;18(4):229-32. doi: 10.1097/NRL.0b013e31825bbf4d.
New imaging techniques have allowed for the rapid and accurate diagnosis of stroke. In this case, we present a 58-year-old woman with multiple large vessel strokes on magnetic resonance imaging. The initial diagnostic workup centered on a rapidly progressive central nervous system vasculitis. Subsequent workup revealed an unusual infectious etiology--cryptococcal meningitis. Although fungal infections can cause vasculitis, this is the first report of a patient with multiple anterior and posterior circulation strokes secondary to Cryptococcus. The diagnosis in cases presenting with encepalopathy and without fever is often delayed.
新的成像技术已能实现对中风的快速准确诊断。在此病例中,我们报告一名58岁女性,磁共振成像显示有多处大血管中风。最初的诊断检查集中在快速进展性中枢神经系统血管炎。后续检查发现了一种不寻常的感染病因——隐球菌性脑膜炎。尽管真菌感染可导致血管炎,但这是首例继发于隐球菌的多例前后循环中风患者的报告。对于出现脑病且无发热症状的病例,诊断往往会延迟。