Dimitriadis Konstantinos, Wenzel Michael, Buchholz Grete, Straube Andreas
Department of Neurology, University Hospital, Ludwig Maximilian University of Munich, Munich, DEU.
Cureus. 2019 Feb 19;11(2):e4089. doi: 10.7759/cureus.4089.
Tumor necrosis factor-α (TNFα) plays a major role in inflammatory and vascular processes after cerebral ischemia. TNFa-Inhibitors have, on the one hand, been associated with thromboembolic events; on the other hand, they may prevent brain edema after stroke or injury. Here, we report on a 38-year old Caucasian male with a history of Crohn´s disease, treated with adalimumab, who presented without brain edema and only minor sequelae after a major ischemic stroke. This case report illustrates two interesting aspects: 1) the treatment with adalimumab could, in that case, be the etiology for the thromboembolic event; and (2) pretreatment with this TNFa-Inhibitor was the most likely reason why the formation of brain edema was suppressed.
肿瘤坏死因子-α（TNFα）在脑缺血后的炎症和血管过程中起主要作用。一方面，TNFα抑制剂与血栓栓塞事件有关；另一方面，它们可能预防中风或损伤后的脑水肿。在此，我们报告一名38岁有克罗恩病病史、接受阿达木单抗治疗的白种男性，其在发生严重缺血性中风后未出现脑水肿且仅有轻微后遗症。本病例报告说明了两个有趣的方面：1）在该病例中，阿达木单抗治疗可能是血栓栓塞事件的病因；2）使用这种TNFα抑制剂进行预处理很可能是脑水肿形成受到抑制的原因。
