Department of Neurology, University Hospital Giessen and Marburg, Klinikstrasse 33, 35392, Giessen, Germany.
Department of Neurology, Buergerhospital Friedberg, Ockstaedter Strasse 3-5, 61169, Friedberg, Germany.
BMC Neurol. 2021 Apr 14;21(1):158. doi: 10.1186/s12883-021-02191-y.
We present the case of a 75-year-old female with acute embolic cerebral infarction caused by a fail-implanted venous port catheter system in the left subclavian artery.
A 75-year-old woman presented to our emergency room after acute onset of a right-sided hemiparesis and dysarthria. Within 2 days after admission, she developed a left-sided hemiparesis, ataxia with concordant gait disturbance and incoordination of the left upper limb. DWI-MRI showed acute multiple infarcts in both cerebral and cerebellar hemispheres. Laboratory examination, 24-h Holter electrocardiography and transthoracic echocardiography provided no pathological findings. Further examination revealed an arterially fail-implanted port catheter, placed in the left subclavian artery with its tip overlying the ascending aorta, as the source of cerebral embolism.
This is the first case report of thromboembolic, cerebral infarction due to a misplaced venous port catheter in the subclavian artery, emphasizing the imperative need for a thorough diagnostic workup, when embolism is suspected but cannot be proven at first glance.
我们报告了一例 75 岁女性因左锁骨下动脉内失败植入的静脉港导管系统导致急性栓塞性脑梗死的病例。
一名 75 岁女性因右侧偏瘫和构音障碍急性发作而到我院急诊就诊。入院后 2 天，她出现左侧偏瘫、共济失调伴左侧上肢运动不协调。DWI-MRI 显示大脑和小脑半球均有急性多发性梗死。实验室检查、24 小时动态心电图和经胸超声心动图均未发现病理性发现。进一步检查发现，动脉内失败植入的静脉港导管位于左锁骨下动脉，其尖端位于升主动脉上方，是导致脑栓塞的原因。
这是首例因锁骨下动脉内静脉港导管位置不当导致血栓栓塞性脑梗死的病例报告，强调了当怀疑栓塞但不能一眼看出时，必须进行彻底的诊断性检查。
