Ogasawara Yoshifumi, Mano Kagari, Henmi Fumiaki, Uesaka Yoshikazu, Takazawa Yutaka
Department of Neurology, Toranomon Hospital.
Department of Neurology, Yokohama Rosai Hospital.
Rinsho Shinkeigaku. 2023 Feb 25;63(2):97-100. doi: 10.5692/clinicalneurol.cn-001816. Epub 2023 Jan 31.
The patient is a 73-year-old woman. She presented with dysarthria, and a head MRI revealed multiple acute cerebral infarctions in the bilateral cerebral hemisphere and cerebellar hemisphere. Transesophageal echocardiography after admission revealed a 16 mm large mobile calcification of the mitral annulus (caseous calcification of the mitral annulus; CCMA) on the posterior apex of the mitral valve annulus. Since the CCMA had a high risk of relapse, and a new infarction was detected on the 8th day, resection of the mass and mitral valve replacement surgery were performed. CCMA is a subtype of mitral annular calcification (MAC). When calcification progresses from the MAC state to form a mass, it is called a calcified amorphous tumor; CAT. Reports of embolic cerebral infarction caused by CAT are rare, but this is a rare report of an embolic cerebral infarction from CCMA presenting as CAT.
患者为一名73岁女性。她出现构音障碍，头部磁共振成像（MRI）显示双侧大脑半球和小脑半球有多处急性脑梗死。入院后经食管超声心动图显示二尖瓣环后尖部有一个16毫米大的活动钙化灶（二尖瓣环干酪样钙化；CCMA）。由于CCMA有较高的复发风险，且在第8天检测到新的梗死灶，遂进行了肿块切除和二尖瓣置换手术。CCMA是二尖瓣环钙化（MAC）的一种亚型。当钙化从MAC状态进展形成肿块时，称为钙化无定形肿瘤；CAT。由CAT引起的栓塞性脑梗死报告很少，但这是一份罕见的由表现为CAT的CCMA引起的栓塞性脑梗死报告。
