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中暑所致急性椎基底动脉供血区梗死

Acute Vertebrobasilar Territory Infarcts due to Heat Stroke.

作者信息

Jain Rajendra Singh, Kumar Sunil, Agarwal Rakesh, Gupta Pankaj Kumar

机构信息

Department of Neurology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India.

Department of Neurology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India.

出版信息

J Stroke Cerebrovasc Dis. 2015 Jun;24(6):e135-8. doi: 10.1016/j.jstrokecerebrovasdis.2015.02.001. Epub 2015 Apr 16.

Abstract

Heat stroke is common in tropical country like India especially during the summer season. We report an unusual case of acute vertebrobasilar territory infarcts due to heat stroke. A middle-aged man developed hyperpyrexia (42.2°C) after strenuous fieldwork in a hot summer day. Next morning, he was found in altered sensorium. The brain imaging showed acute posteromedial midbrain and cerebellar infarcts. A diagnosis of acute ischemic stroke due to heat stroke was made, and the patient was put under the intensive care unit. Two weeks later, the patient became conscious, but had slurred speech and incoordination in all the 4 limbs. Six months after rehabilitation, the patient still have scanning speech and limb ataxia. Acute ischemic stroke worsened the prognosis in our patient. Acute infarct is a very rare neurologic manifestation of heat stroke. This case report emphasizes the importance of suspecting acute infarct in heat stroke patient.

摘要

中暑在印度这样的热带国家很常见,尤其是在夏季。我们报告一例因中暑导致急性椎基底动脉供血区梗死的罕见病例。一名中年男子在炎热夏日进行剧烈野外工作后出现高热(42.2°C)。次日清晨,发现他意识改变。脑部影像学检查显示急性中脑后内侧和小脑梗死。诊断为中暑所致急性缺血性卒中,患者被收入重症监护病房。两周后,患者意识恢复,但言语含糊,四肢共济失调。康复六个月后,患者仍有吟诗样言语和肢体共济失调。急性缺血性卒中使我们这位患者的预后恶化。急性梗死是中暑非常罕见的神经学表现。本病例报告强调了在中暑患者中怀疑急性梗死的重要性。

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