Department of Neurology, Heyuan People's Hospital, Guangdong Provincial People's Hospital Heyuan Hospital, Guangdong Province, China.
Medicine (Baltimore). 2022 Jul 8;101(27):e29445. doi: 10.1097/MD.0000000000029445.
Cerebrovascular fenestration malformation is a relatively rare vascular dysplasia, and an 8-shaped basilar artery fenestration malformation is even rarer. The characteristics of transcranial Doppler cerebral blood flow in cerebrovascular fenestration malformations have rarely been studied or reported.
A 58-year-old woman presented with hypertension, diabetes, with no history of smoking or drinking. The patient had no relevant family history. The patient experienced left limb weakness for 2 days, which gradually worsened.
Head and neck computed tomography angiography revealed an 8-shaped fenestration deformity of the lower segment of the basilar artery with multiple stenoses of the local vessels. Transcranial Doppler cerebral blood flow examination at a depth of 85 cm revealed an eddy current in the lower segment of the basilar artery.
Tirofiban was administered intravenously for 3 days and subsequently changed to oral clopidogrel antiplatelet treatment.
The modified Rankin Scale score at 3 months after disease onset was 0, indicating that the patient recovered well after treatment.
A basilar artery 8-shaped fenestration is extremely rare and has seldom been reported. Cerebral vascular fenestration can lead to an acute cerebral infarction and its pathogenesis may include local hemodynamic abnormalities and thrombosis. Eddy currents can be detected by transcranial Doppler cerebral blood flow examination.
脑血管窗畸形是一种相对罕见的血管发育不良，而 8 字形基底动脉窗畸形则更为罕见。脑血管窗畸形的经颅多普勒脑血流特征很少被研究或报道。
一名 58 岁女性，有高血压、糖尿病病史，无吸烟和饮酒史。患者无相关家族史。患者出现左肢无力 2 天，逐渐加重。
头颈部 CT 血管造影显示基底动脉下段呈 8 字形窗畸形，局部血管多处狭窄。经颅多普勒脑血流检查深度 85cm 处显示基底动脉下段出现涡流。
静脉给予替罗非班 3 天，随后改为口服氯吡格雷抗血小板治疗。
发病后 3 个月改良 Rankin 量表评分为 0，提示患者治疗后恢复良好。
基底动脉 8 字形窗畸形极为罕见，鲜有报道。脑血管窗可导致急性脑梗死，其发病机制可能包括局部血流动力学异常和血栓形成。经颅多普勒脑血流检查可检测到涡流。
