新型部分肺静脉畸形连接合并脑脓肿。
Novel partial anomalous pulmonary venous connection associated with brain abscess.
机构信息
Department of Cardiology, Thomas Jefferson University, Philadelphia, PA, USA.
Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
出版信息
J Clin Neurol. 2014 Jan;10(1):55-8. doi: 10.3988/jcn.2014.10.1.55. Epub 2014 Jan 6.
BACKGROUND
Right-to-left vascular shunts are associated with brain abscess.
CASE REPORT
We present a 47-year-old female with a cryptogenic left thalamic abscess on which Streptococcus mitis grew upon aspiration. Computed tomography of the chest with contrast agent revealed an anomalous connection between the left superior pulmonary and brachiocephalic veins. A right-to-left shunt was confirmed in a transthoracic echocardiogram study in which bubbles were injected into the left arm; this shunt had not previously been noted upon right-arm injection.
CONCLUSIONS
We recommend aggressive evaluation for right-to-left shunts in patients who present with cryptogenic brain abscesses. In addition to imaging, this should include a bubble-based study with left-arm saline injection.
背景
左右分流血管与脑脓肿有关。
病例报告
我们报告了一名 47 岁女性，其左侧丘脑隐源性脓肿抽吸物中生长出米氏链球菌。胸部 CT 造影剂显示左上肺静脉和头臂静脉之间存在异常连接。经胸超声心动图研究证实存在右向左分流，将微泡注入左臂，而之前右臂注射时未发现该分流。
结论
对于出现隐源性脑脓肿的患者，我们建议积极评估是否存在右向左分流。除影像学检查外，还应包括左侧臂生理盐水注射的基于微泡的研究。
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