Kamo Hikaru, Miyamoto Nobukazu, Otani Hana, Kurita Naohide, Nakajima Sho, Ueno Yuji, Yamashiro Kazuo, Tanaka Ryota, Hattori Nobutaka
Department of Neurology, Juntendo University Hospital, Bunkyo, Tokyo, Japan.
Department of Neurology, Juntendo University Hospital, Bunkyo, Tokyo, Japan.
J Stroke Cerebrovasc Dis. 2018 Nov;27(11):3095-3099. doi: 10.1016/j.jstrokecerebrovasdis.2018.06.038. Epub 2018 Aug 2.
Capsular warning syndrome (CWS) is characterized by recurrent conventional episodes of motor and/or sensory deficits without cortical symptoms. The purpose of this case series study was to evaluate the safety and appropriate treatment for CWS to prevent the development of complete stroke.
We reviewed our hospital records and previous reports to find patients with neurologically fluctuating profiles, and excluded those with unknown details of initial treatment/final treatment of antiplatelet therapy or radiological findings.
We retrieved two cases of CWS from our hospital, which presented motor and/or sensory symptoms followed by complete resolution without complete ischemia. The recurring episodes in both were unable to be stabilized by single antiplatelet therapy but were successfully managed using two or more antiplatelet drugs. In 11 previously reported cases of CWS, the recurring episode was frequency stabilized with plural antiplatelet therapy.
Multiplicate antiplatelet therapy is important for treatment of CWS, and caution is needed regarding hemorrhagic complications.
包膜警告综合征（CWS）的特征是反复出现无皮质症状的运动和/或感觉功能缺损的常规发作。本病例系列研究的目的是评估CWS的安全性和适当治疗方法，以预防完全性中风的发生。
我们查阅了医院记录和既往报告，以寻找神经功能波动的患者，并排除了抗血小板治疗初始治疗/最终治疗细节或影像学检查结果不明的患者。
我们从医院检索到2例CWS病例，这些病例出现运动和/或感觉症状，随后完全缓解，未出现完全缺血。两例复发性发作均无法通过单一抗血小板治疗稳定，但使用两种或更多种抗血小板药物成功控制。在之前报道的11例CWS病例中，复发性发作通过多种抗血小板治疗频率得以稳定。
多重抗血小板治疗对CWS的治疗很重要，需要注意出血并发症。
