Arai Nobuhiko, Yachi Kazunari, Ishihara Ryutaro, Fukushima Takao
Department of Neurosurgery, Takashimadaira Central General Hospital, Itabashiku, Tokyo, Japan.
Surg Neurol Int. 2022 Apr 29;13:179. doi: 10.25259/SNI_252_2022. eCollection 2022.
Adenomyosis is a common and benign uterine disease. Acute cerebral infarction (CI) associated with adenomyosis is rarely reported and difficult to treat. We experienced successful treatment for this disease.
A 50-year-old woman presented with a 2-day history of visual disturbance. Magnetic resonance imaging showed multiple tiny diffusion-weighted high-density spots on several lobes. No common risk factors for stroke were detected. Cancer antigen 125 level was 999 U/mL, along with massively expanded uterus and adnexa. Based on the diagnosis of benign adenomyosis, Xa inhibitor and GnRH agonists were administered for CI and adenomyosis, respectively. Acute CI recurred 7 days after admission. We suspected a relationship between infarction and adenomyosis and concluded hysterectomy as a proper treatment strategy based on the literature. Eighteen months after hysterectomy, no recurrence of CI without anti-thrombus medications has been detected.
Hysterectomy is a radical therapy that is effective in preventing acute CI due to adenomyosis associated with ischemic symptoms.
子宫腺肌病是一种常见的良性子宫疾病。与子宫腺肌病相关的急性脑梗死（CI）鲜有报道且治疗困难。我们成功治疗了该疾病。
一名50岁女性出现视力障碍2天。磁共振成像显示多个脑叶上有多个微小的弥散加权高密度斑点。未检测到常见的中风危险因素。癌抗原125水平为999 U/mL，同时子宫和附件大量增大。基于良性子宫腺肌病的诊断，分别给予Xa抑制剂和促性腺激素释放激素激动剂治疗CI和子宫腺肌病。入院7天后急性CI复发。我们怀疑梗死与子宫腺肌病之间存在关联，并根据文献得出子宫切除术是一种合适的治疗策略。子宫切除术后18个月，未检测到在未使用抗血栓药物的情况下CI复发。
子宫切除术是一种根治性治疗方法，对预防因与缺血症状相关的子宫腺肌病导致的急性CI有效。
