Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
BMC Neurol. 2020 May 25;20(1):210. doi: 10.1186/s12883-020-01787-0.
It is reported that acute cerebral infarction with adenomyosis is associated with elevated D-Dimer, elevated CA125, anemia and menstruation. However, previous reports did not notice infection known as fever, which may be a potential risk factor for developing acute cerebral infarction with adenomyosis.
We describe a 34-year-old woman who presented headache and fever (38 °C) for 4 days and left limb weakness for 1 day during her menstrual phase. Laboratory test data showed: Hemoglobin (HGB) (112 g/L, normal: 120-150 g/L), Carcinoembryonic antigen 125 (CA125) (937.70 U/ml, normal: 0-35 U/ml), D-Dimer (27.4 mg/L, normal: 0-1.5 mg/L). Magnetic resonance imaging (MRI) indicated acute cerebral infarction in right basal ganglia and subcortical region of right frontotemporal lobe. Further, brain computed tomography angiography (CTA) showed that the M1 segment of right middle cerebral artery was strictured and the distal branches of right middle cerebral artery were significantly less than those on the opposite side. No obvious abnormality was found in cranial magnetic resonance venogram (MRV). She had a 5-year history of adenomyosis. No tumors were found by whole body positron emission tomography-computed tomography (PET-CT). We treated this patient by using anti-infective therapy for 1 week and using anticoagulant therapy with low molecular weight heparin for 2 weeks. Subsequently, the anticoagulant therapy was discontinued and replaced by antiplatelet therapy with clopidogrel. We followed up this patient for 4 months, and no recurrence of cerebral infarction was found.
Acute cerebral infarction with adenomyosis may be related to elevated D-Dimer, elevated CA125, anemia and menstruation. Our report suggests that infection may be a potential risk factor for developing acute cerebral infarction with adenomyosis.
据报道，腺肌病合并急性脑梗死与 D-二聚体升高、CA125 升高、贫血和月经有关。然而，以往的报道并未注意到感染即发热，这可能是发生腺肌病合并急性脑梗死的潜在危险因素。
我们描述了一位 34 岁女性，在月经期出现头痛和发热（38℃）4 天，左肢无力 1 天。实验室检查数据显示：血红蛋白（HGB）（112g/L，正常：120-150g/L）、癌胚抗原 125（CA125）（937.70U/ml，正常：0-35U/ml）、D-二聚体（27.4mg/L，正常：0-1.5mg/L）。磁共振成像（MRI）提示右侧基底节和右侧额颞叶皮质下区急性脑梗死。进一步，脑计算机断层血管造影（CTA）显示右侧大脑中动脉 M1 段狭窄，右侧大脑中动脉远端分支明显少于对侧。颅磁共振静脉造影（MRV）未见明显异常。患者有 5 年腺肌病史。全身正电子发射断层扫描-计算机断层扫描（PET-CT）未发现肿瘤。我们给予抗感染治疗 1 周，低分子肝素抗凝治疗 2 周。随后，停止抗凝治疗，改用氯吡格雷抗血小板治疗。我们对该患者进行了 4 个月的随访，未发现脑梗死复发。
腺肌病合并急性脑梗死可能与 D-二聚体升高、CA125 升高、贫血和月经有关。我们的报告提示感染可能是发生腺肌病合并急性脑梗死的潜在危险因素。
