Nakanishi Kaoru, Kawano Hiroyuki, Amano Tatsuo, Omori Yoshihiko, Kanma Hiroshi, Hirano Teruyuki
Department of Stroke and Cerebrovascular Medicine, Kyorin University.
Department of Pathology, Kyorin University.
Rinsho Shinkeigaku. 2018 Jan 26;58(1):35-40. doi: 10.5692/clinicalneurol.cn-001099. Epub 2017 Dec 22.
A 80-years-old woman suddenly presented with aphasia, right hemiparesis, and dysesthesia. MRA showed the left middle cerebral artery occlusion. She was diagnosed as hyperacute ischemic stroke. She was treated with intravenous recombinant tissue plasminogen activator and underwent endovascular thrombectomy. On admission, she had a fever and high C reactive protein, and was treated with antibiotic therapy. The pathological diagnosis of the retrieved thrombus revealed the cluster of the gram positive cocci. The blood culture was negative and thransthoracic echocardiogram did not detect the vegetation. She was finally diagnosed as cardioembolic stroke due to infective endocarditis based on the pathological diagnosis of the retrieved thrombus. The pathological diagnosis of the retrieved thrombus was quite important to clarify the cause of ischemic stroke.
一名80岁女性突然出现失语、右侧偏瘫和感觉障碍。磁共振血管造影（MRA）显示左侧大脑中动脉闭塞。她被诊断为超急性缺血性中风。她接受了静脉注射重组组织型纤溶酶原激活剂治疗，并接受了血管内血栓切除术。入院时，她发热且C反应蛋白升高，接受了抗生素治疗。取出血栓的病理诊断显示革兰氏阳性球菌簇。血培养阴性，经胸超声心动图未检测到赘生物。基于取出血栓的病理诊断，她最终被诊断为感染性心内膜炎所致的心源性栓塞性中风。取出血栓的病理诊断对于明确缺血性中风的病因非常重要。
