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病例报告:1例卒中患者经血管内激光血液照射后交叉性小脑失联络快速改善

Case report: Rapid improvement of crossed cerebellar diaschisis after intravascular laser irradiation of blood in a case of stroke.

作者信息

Yang Wan-Hua, Lin Shiou-Ping, Chang Shin-Tsu

机构信息

Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan.

出版信息

Medicine (Baltimore). 2017 Jan;96(2):e5646. doi: 10.1097/MD.0000000000005646.

DOI:10.1097/MD.0000000000005646
PMID:28079797
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5266159/
Abstract

RATIONALE

Crossed cerebellar diaschisis (CCD) is a poor prognostic factor after stroke because without immediate cerebral reperfusion no further improvements in the patient's condition can be achieved. We investigated the clinical effects of intravascular laser irradiation therapy (ILIB) on CCD and evaluated the therapeutic effect in the sub-acute post-stroke stage.

PATIENT CONCERNS

The 77-year-old male with cerebral infarction in the territory of the right anterior cerebral artery only underwent conservative treatment including hydration and aspirin in the acute post-stroke stage.

DIAGNOSIS

He was diagnosed as stroke based on the clinical presentations and imaging findings.

INTERVENTION

Once the patient was in stable condition, he underwent a daily hour-long ILIB (He-Ne laser) for ten consecutive days during the sub-acute post-stroke stage.

OUTCOMES

We used single-photon emission computed tomography (SPECT) before and after intravascular laser irradiation to detect changes in cerebral and cerebellar perfusion. Then, we compared the two images. CCD was detected using the first SPECT. After intervention by ILIB, the second SPECT showed greater perfusion in the affected cerebellar hemisphere.

LESSONS

We found that ILIB helped eliminate CCD, which was previously shown to be an untreatable condition using any intervention during the sub-acute post-stroke stage. Stroke patients could therefore greatly benefit from ILIB.

摘要

理论依据

交叉性小脑机能联系障碍(CCD)是卒中后预后不良的因素,因为若不立即实现脑再灌注,患者病情就无法进一步改善。我们研究了血管内激光照射疗法(ILIB)对CCD的临床效果,并评估了其在卒中后亚急性期的治疗效果。

患者情况

这位77岁男性,仅在右大脑前动脉区域发生脑梗死,在卒中后急性期仅接受了包括补液和阿司匹林在内的保守治疗。

诊断

根据临床表现和影像学检查结果,他被诊断为卒中。

干预措施

患者病情稳定后,在卒中后亚急性期连续10天每天接受1小时的ILIB(氦氖激光)治疗。

结果

我们在血管内激光照射前后使用单光子发射计算机断层扫描(SPECT)检测大脑和小脑灌注的变化。然后,我们比较了这两张图像。通过首次SPECT检测到CCD。经ILIB干预后,第二次SPECT显示患侧小脑半球灌注增加。

经验教训

我们发现ILIB有助于消除CCD,而之前显示在卒中后亚急性期使用任何干预措施都无法治疗CCD。因此,卒中患者可从ILIB中大大受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7974/5266159/9199a97cf588/medi-96-e5646-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7974/5266159/329816577626/medi-96-e5646-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7974/5266159/4f5e976867da/medi-96-e5646-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7974/5266159/9199a97cf588/medi-96-e5646-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7974/5266159/329816577626/medi-96-e5646-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7974/5266159/4f5e976867da/medi-96-e5646-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7974/5266159/9199a97cf588/medi-96-e5646-g003.jpg

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