Kobayashi Yuya, Yahikozawa Hiroyuki, Takamatsu Ryota, Watanabe Rie, Hoshi Kenichi, Ishii Wataru, Sato Shunichi
Department of Neurology, Nagano Red Cross Hospital, Nagano, Japan.
Department of Neurology, Nagano Red Cross Hospital, Nagano, Japan.
J Stroke Cerebrovasc Dis. 2017 Sep;26(9):e177-e179. doi: 10.1016/j.jstrokecerebrovasdis.2017.06.034. Epub 2017 Jul 19.
Cerebral embolism is typically caused by a cardiogenic thrombus. The patent foramen ovale is a well-known cause of paradoxical embolism. However, some idiopathic cases of stroke have been reported. Such strokes are designated as embolic stroke of undetermined sources. Among them, lung lobectomy may be a new embolic risk factor for cerebral embolism. The risk of thrombus formation is high at the pulmonary vein stump after lung lobectomy, especially in the left upper lobe. Interestingly, the risk remains several years after surgery. This condition is mostly overlooked, and reported cases of this condition are rare. Methods of early detection, prevention, and treatment have not been established. Here we report the case of a 66-year-old man who suffered a cerebral infarction 2 days after left upper lobectomy. Three-dimensional computed tomography scan clearly revealed the structural feature of the pulmonary vein stump. The stump of patients with cerebral infarction after lung lobectomy should be checked.
脑栓塞通常由心源性血栓引起。卵圆孔未闭是反常栓塞的一个众所周知的原因。然而，已有一些特发性中风病例的报道。此类中风被称为来源不明的栓塞性中风。其中，肺叶切除术可能是脑栓塞的一个新的栓塞危险因素。肺叶切除术后肺静脉残端形成血栓的风险很高，尤其是在左上叶。有趣的是，这种风险在手术后数年仍然存在。这种情况大多被忽视，且报道的此类病例很少。早期检测、预防和治疗方法尚未确立。在此，我们报告一例66岁男性在左上叶切除术后2天发生脑梗死的病例。三维计算机断层扫描清晰显示了肺静脉残端的结构特征。肺叶切除术后发生脑梗死患者的残端应进行检查。
