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双侧丘脑前部对称性梗死:病例研究。

Bilateral anterior thalamic symmetrical infarction: a case study.

机构信息

Affiliated Hospital of Shandong University of Traditional Chinese Medicine, 250014, Jinan, China.

Shandong University of Traditional Chinese Medicine, 250355, Jinan, China.

出版信息

BMC Neurol. 2023 May 6;23(1):184. doi: 10.1186/s12883-023-03226-2.

Abstract

BACKGROUND

Bilateral anterior thalamic symmetrical infarction is very rarely observed in clinical practice and has rarely been reported in the literature. In this paper we introduce a patient with bilateral anterior thalamic symmetrical infarction and discuss his symptoms, treatment process, and follow-up visit results, as well as the potential pathological mechanisms of the disease.

CASE PRESENTATION

A 71-year-old male had a sudden cognitive decline four days prior to medical consultation. The patient's brain MRI showed symmetrical high signals in the anterior part of both sides of the thalamus. The patient's head MRV and immunological tests were normal, and we considered that this patient had a rare case of bilateral anterior thalamic infarction. After 10 days of anti-platelet aggregation that lowered blood lipids and improved circulation, the patient's symptoms significantly abated. Two years later, we found through telephone follow-up that the patient's symptoms had not relapsed substantially and that he was able to perform self-care, having only continued to suffer a slight decline in short-term memory.

CONCLUSION

For patients with bilateral prethalamic lesions who have only acute cognitive impairment, if the lesions conform to the blood supply area of both thalamic nodular arteries and DWI shows a high signal, the diagnosis of acute cerebral infarction should be considered, and the standard treatment plan for cerebral infarction should be given as soon as possible.

摘要

背景

双侧丘脑前对称性梗死在临床实践中非常罕见,文献中也鲜有报道。本文介绍了一例双侧丘脑前对称性梗死患者,并对其症状、治疗过程及随访结果进行了讨论,同时探讨了该病的潜在病理机制。

病例介绍

一名 71 岁男性,在就诊前 4 天突然出现认知能力下降。患者的脑部 MRI 显示双侧丘脑前部对称性高信号。患者的头部 MRV 和免疫检查正常,我们考虑该患者为双侧丘脑前梗死的罕见病例。经过 10 天的抗血小板聚集、降血脂和改善循环治疗后,患者的症状明显缓解。2 年后,我们通过电话随访发现,患者的症状没有明显复发,他能够进行自我护理,只是短期记忆仍略有下降。

结论

对于双侧丘脑前病变且仅表现为急性认知障碍的患者,如果病变符合双侧丘脑结节动脉供血区,DWI 呈高信号,应考虑急性脑梗死的诊断,并尽快给予脑梗死的标准治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de0e/10163735/4be1dd60b9a9/12883_2023_3226_Fig1_HTML.jpg

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