Yoshida Takeshi, Ouchi Atsushi, Miura Daisuke, Shimoji Kunihiro, Kinjo Kazushi, Sueyoshi Takeshi, Jonosono Manabu, Rajput Vijay
Department of Neurology, Okinawa Chubu Hospital, Japan.
Intern Med. 2013;52(12):1389-92. doi: 10.2169/internalmedicine.52.0188.
A 26-year-old woman was admitted due to an altered mental status and generalized tonic-clonic seizures. She had experienced chronic migraine-like headaches, progressive bilateral hearing loss, a short stature and nephrotic syndrome. Laboratory data showed elevated lactate and pyruvate levels. Brain MRI using diffusion-weighted imaging revealed a hyperintense lesion in the left temporal lobe. MR angiography revealed segmental stenosis at the C1 and M1-2 junction. A genetic study revealed a mitochondrial DNA A3243G point mutation. The patient's clinical symptoms and MRI/MR angiography (MRA) findings improved within four weeks. We herein discuss the possible pathophysiology involving both stroke-like episodes and reversible vasoconstriction.
一名26岁女性因精神状态改变和全身性强直阵挛发作入院。她曾经历慢性偏头痛样头痛、进行性双侧听力丧失、身材矮小和肾病综合征。实验室数据显示乳酸和丙酮酸水平升高。使用弥散加权成像的脑部MRI显示左颞叶有一个高信号病变。磁共振血管造影显示C1和M1-2交界处节段性狭窄。基因研究发现线粒体DNA A3243G点突变。患者的临床症状以及MRI/磁共振血管造影（MRA）结果在四周内有所改善。我们在此讨论涉及类中风发作和可逆性血管收缩的可能病理生理学。
