Department of Stroke Treatment, Shonan Kamakura General Hospital Stroke Center, Kamakura, Japan.
Department of Stroke Treatment, Shonan Kamakura General Hospital Stroke Center, Kamakura, Japan.
J Stroke Cerebrovasc Dis. 2019 Nov;28(11):104365. doi: 10.1016/j.jstrokecerebrovasdis.2019.104365. Epub 2019 Sep 14.
A 64-year-old woman was admitted to our hospital 48 minutes after sudden onset of dysphasia and right hemiplegia. Head computed tomography revealed small infarcts in the left putamen and 4-dimensional computed tomography angiography depicted high-degree stenosis in the left middle cerebral artery and delayed filling of the contrast media in the left middle cerebral artery territory. The patient underwent intravenous tissue plasminogen activator treatment. On day 5 of hospitalization, the patient underwent conventional cerebral angiography, revealing internal carotid artery to middle cerebral artery dissection. Fortunately, subarachnoid hemorrhage as an adverse effect did not occur, although iv-tPA was administered without detecting middle cerebral artery dissection.
一位 64 岁女性突发语言障碍和右侧偏瘫后 48 分钟被收入我院。头部 CT 显示左侧壳核有小梗死灶，4D-CTA 显示左侧大脑中动脉高度狭窄，左侧大脑中动脉区域对比剂充盈延迟。患者接受了静脉溶栓治疗。入院第 5 天行常规脑血管造影，发现颈内动脉-大脑中动脉夹层。虽然给予了 iv-tPA，但未发现大脑中动脉夹层，幸运的是没有发生蛛网膜下腔出血等不良反应。
