Khan Shaida, Chang Eric, Saniuk Georgia, Shang Ty
Department of Neurology & Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas.
School of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
J Stroke Cerebrovasc Dis. 2015 Jan;24(1):e29-30. doi: 10.1016/j.jstrokecerebrovasdis.2014.08.016. Epub 2014 Nov 8.
Asterixis as limb-shaking transient ischemic attack (TIA) is rare and poorly understood. Bilateral asymmetrical asterixis as limb-shaking TIA has not been reported in carotid stenosis. A 69-year-old gentleman presented with a TIA episode (dysarthria, right-arm weakness, and numbness). Bilateral asterixis was observed and was more severe on the right side. No prior infarcts were noted in the thalamus. Liver function was normal. A computerized tomography angiogram revealed 85%stenosis of the right internal carotid artery (ICA) and 65% stenosis of the left ICA. Three days after left ICA endarterectomy, the patient had complete disappearance of bilateral asterixis, with the right side showing initial improvement. The bilateral asterixis observed is proposed to be secondary to hemodynamic impairment and hypoperfusion of certain brain territory with resolution on revascularization.
扑翼样震颤作为肢体抖动性短暂性脑缺血发作（TIA）较为罕见且了解甚少。双侧不对称性扑翼样震颤作为肢体抖动性TIA在颈动脉狭窄中尚未见报道。一名69岁男性出现TIA发作（构音障碍、右臂无力和麻木）。观察到双侧扑翼样震颤，右侧更严重。丘脑未见既往梗死灶。肝功能正常。计算机断层血管造影显示右侧颈内动脉（ICA）狭窄85%，左侧ICA狭窄65%。左侧ICA内膜切除术后三天，患者双侧扑翼样震颤完全消失，右侧最初有所改善。观察到的双侧扑翼样震颤被认为是继发于血流动力学损害和特定脑区灌注不足，血管再通后症状缓解。
