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心房颤动相关性心脑梗死的血管内治疗:一例病例报告及文献综述

Endovascular therapy for cardiocerebral infarction associated with atrial fibrillation: A case report and literature review.

作者信息

Nakajima Hideki, Tsuchiya Takuro, Shimizu Shigetoshi, Watanabe Kiyotaka, Kitamura Tetsuya, Suzuki Hidenori

机构信息

Department of Neurosurgery, Suzuka General Hospital, Suzuka, Japan.

Department of Cardiology, Suzuka General Hospital, Suzuka, Japan.

出版信息

Surg Neurol Int. 2022 Oct 21;13:479. doi: 10.25259/SNI_593_2022. eCollection 2022.

Abstract

BACKGROUND

Cardiocerebral infarction (CCI) is a rare entity that refers to the simultaneous occurrence of acute myocardial infarction and acute ischemic stroke. The management of CCI patients remains unclear.

CASE DESCRIPTION

An 86-year-old woman with a medical history of paroxysmal atrial fibrillation presented with a sudden onset of consciousness disturbance and right hemiplegia. Computed tomography of the head revealed no intracranial hemorrhage but the left hyperdense middle cerebral artery sign, associated with ST-segment elevation in II, III, and aVF noted on a routine 12-lead electrocardiogram at admission. The patient was immediately brought to the catheterization laboratory and percutaneous coronary intervention (PCI) was performed first, followed by mechanical thrombectomy, resulting in successful revascularization of the both diseases.

CONCLUSION

Although the treatment strategy of CCI may depend on the condition of coronary and cerebral ischemia, it may be appropriate to prioritize coronary angiography and PCI if not acute ischemic stroke is critical.

摘要

背景

心脑梗死(CCI)是一种罕见的病症,指急性心肌梗死和急性缺血性卒中同时发生。CCI患者的治疗方法仍不明确。

病例描述

一名86岁有阵发性心房颤动病史的女性,突然出现意识障碍和右侧偏瘫。头部计算机断层扫描显示无颅内出血,但有左侧大脑中动脉高密度征,入院时常规12导联心电图显示Ⅱ、Ⅲ和aVF导联ST段抬高。患者立即被送往导管室,首先进行了经皮冠状动脉介入治疗(PCI),随后进行了机械取栓术,两种疾病均成功实现血管再通。

结论

尽管CCI的治疗策略可能取决于冠状动脉和脑缺血的情况,但如果急性缺血性卒中不危急,优先进行冠状动脉造影和PCI可能是合适的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/988d/9609951/2cb17ea40ddd/SNI-13-479-g001.jpg

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本文引用的文献

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