一例复发性缺血性卒中病例，该病例在诊断为JAK2突变型真性红细胞增多症之前存在亚急性、进行性颅内脑动脉硬化。
A Case of Recurrent Ischemic Stroke Involving Subacute, Progressive Intracranial Cerebral Arterial Sclerosis Prior to Diagnosis with JAK2-mutated Polycythemia Vera.
作者信息
Nezu Tomohisa, Aoki Shiro, Ochi Kazuhide, Sugihara Sayaka, Takahashi Tetsuya, Hosomi Naohisa, Maruyama Hirofumi, Matsumoto Masayasu
机构信息
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
出版信息
J Stroke Cerebrovasc Dis. 2015 Dec;24(12):e4-6. doi: 10.1016/j.jstrokecerebrovasdis.2015.08.040. Epub 2015 Oct 1.
CASE REPORT
A 58-year-old man presenting with no vascular risk factors visited our hospital with right hemiparesis and total aphasia. Diffusion-weighted magnetic resonance imaging of the brain showed multiple hyperintensities in watershed distributions in the left hemisphere. Magnetic resonance angiography (MRA) revealed stenosis of the middle cerebral artery, despite normal MRA findings 2 months prior. One year after the first stroke, the patient experienced a recurrent ischemic stroke involving the left anterior choroidal artery, pulmonary embolism, and deep venous thrombosis. After the recurrent stroke event, hemoglobin levels increased gradually. Two years after the first stroke, a JAK2V-617F mutation was detected.
CONCLUSION
Our report suggests that progressive intracranial arterial sclerosis and venous thrombosis of undetermined etiologies could be several initial symptoms of polycythemia vera.
病例报告
一名无血管危险因素的58岁男性因右侧偏瘫和完全性失语前来我院就诊。脑部弥散加权磁共振成像显示左半球分水岭区有多个高信号。磁共振血管造影（MRA）显示大脑中动脉狭窄，尽管2个月前MRA检查结果正常。首次中风一年后，患者发生复发性缺血性中风，累及左脉络膜前动脉、肺栓塞和深静脉血栓形成。复发性中风事件后，血红蛋白水平逐渐升高。首次中风两年后，检测到JAK2 V617F突变。
结论
我们的报告表明，病因不明的进行性颅内动脉硬化和静脉血栓形成可能是真性红细胞增多症的几种初始症状。
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