Matsumoto Hiroaki, Yoshida Yasuhisa
Department of Neurosurgery, Eisyokai Yoshida Hospital, Kobe, Japan.
J Korean Neurosurg Soc. 2013 Nov;54(5):411-4. doi: 10.3340/jkns.2013.54.5.411. Epub 2013 Nov 30.
The authors present a rare case of adult moyamoya disease in which a patient experienced rapid progression of cerebral infarction after intraventricular hemorrhage (IVH). A healthy 39-year-old woman was admitted to our hospital with sudden headache, a decreased level of consciousness and mild tetraparesis. Initial magnetic resonance imaging revealed small cerebral infarction and IVH. Although the patient underwent conservative therapy including hypervolemia, hemodilution, keeping moderate hypertension and administration of a free radical scavenger, she showed a fulminant clinical course of cerebral infarction. The authors discuss the possible pathophysiology and suggest the treatment for such cases.
作者报告了一例罕见的成人烟雾病病例，该患者在脑室内出血（IVH）后出现脑梗死快速进展。一名39岁健康女性因突发头痛、意识水平下降和轻度四肢轻瘫入住我院。最初的磁共振成像显示有小面积脑梗死和IVH。尽管患者接受了包括扩容、血液稀释、维持适度高血压以及给予自由基清除剂在内的保守治疗，但她仍表现出脑梗死的暴发性临床病程。作者讨论了可能的病理生理学机制并提出了此类病例的治疗方法。
