Huang Shiwei, Williams Cameron, Thomas James, Khalil Najwa, Wenderoth Jason, Parsons Mark
Department of Interventional Radiology, Liverpool Hospital, Liverpool, New South Wales, Australia.
Department of Neurology, Liverpool Hospital, Liverpool, New South Wales, Australia.
BMJ Case Rep. 2023 May 15;16(5):e252540. doi: 10.1136/bcr-2022-252540.
We present a case of a woman in her 60s with acute left hemispheric ischaemic stroke syndrome due to tandem occlusions of the proximal left internal carotid artery and left middle cerebral artery. This was treated with emergent carotid artery stenting and endovascular clot retrieval. The patient made a complete recovery and was discharged home only to represent a few days later with focal neurological symptoms, profound headache and labile blood pressure. The diagnostic and management challenges of reversible cerebral vasoconstriction syndrome, including imaging assessment and the importance of avoiding 'diagnostic anchoring' are discussed.
我们报告了一例60多岁女性患者，因左侧颈内动脉近端和左侧大脑中动脉串联闭塞，出现急性左半球缺血性中风综合征。该患者接受了紧急颈动脉支架置入术和血管内血栓清除术。患者完全康复并出院回家，但几天后再次出现局灶性神经症状、严重头痛和血压不稳定。文中讨论了可逆性脑血管收缩综合征的诊断和管理挑战，包括影像学评估以及避免“诊断锚定”的重要性。
