一名甲状腺毒症女性因心源性栓塞性卒中导致凸面蛛网膜下腔出血：病例报告

Convexity Subarachnoid Hemorrhage Due to Cardioembolic Stroke in a Woman with Thyrotoxicosis: Α Case Report.

作者信息

Spanou Ioanna, Vassilopoulou Sophia, Koroboki Eleni, Tountopoulou Argyro, Velonakis Georgios, Mitsikostas Dimos Dimitrios

机构信息

First Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

J Stroke Cerebrovasc Dis. 2017 Oct;26(10):e195-e196. doi: 10.1016/j.jstrokecerebrovasdis.2017.06.045. Epub 2017 Aug 2.

DOI:10.1016/j.jstrokecerebrovasdis.2017.06.045

PMID:28780251

Abstract

BACKGROUND

Non-traumatic convexity subarachnoid hemorrhage (cSAH) is a rarely reported condition with a wide spectrum of etiologies. Cerebral ischemia secondary to extracranial or intracranial atherosclerotic disease has been identified as a relatively uncommon cause of cSAH.

CASE REPORT

We report a case of cSAH caused by cardioembolic stroke. A 69-year old female patient developed suddenly left-sided face and body weakness and numbness and visual neglect on the left. She was newly detected with paroxysmal atrial fibrillation on the ground of thyrotoxicosis. Brain magnetic resonance imaging revealed ischemia of embolic pattern with cSAH. Further evaluation excluded other cause of hemorrhage. Dilation of leptomeningeal collateral vessels and rupture of pial vessels in distal cortical arteries may caused cSAH. Full anticoagulation was initiated. After one month, her condition improved significantly (NIHSS from 6 to 2).

CONCLUSIONS

cSAH may be a rare complication of cardioembolic stroke.

摘要

背景

非创伤性凸面蛛网膜下腔出血（cSAH）是一种病因广泛但报道较少的疾病。颅外或颅内动脉粥样硬化疾病继发的脑缺血已被确定为cSAH相对少见的病因。

病例报告

我们报告一例由心源性栓塞性卒中导致的cSAH病例。一名69岁女性患者突然出现左侧面部及身体无力、麻木以及左侧偏盲。因甲状腺毒症新发现阵发性心房颤动。脑部磁共振成像显示为栓塞型缺血伴cSAH。进一步评估排除了其他出血原因。软脑膜侧支血管扩张和皮质远端动脉软脑膜血管破裂可能导致cSAH。开始进行充分抗凝治疗。1个月后，她的病情显著改善（美国国立卫生研究院卒中量表评分从6分降至2分）。