Biller J, Johnson M R, Adams H P, Kerber R E, Toffol G J, Butler M J
Stroke. 1986 Jul-Aug;17(4):608-12. doi: 10.1161/01.str.17.4.608.
We reviewed echocardiographic findings in patients aged 15 to 45 years with acute nonhemorrhagic cerebral infarction (NHCI). Among 132 patients with NHCI, 96 (72.7%) had M-mode and two-dimensional echocardiography, including contrast echocardiography with intravenous saline injection when clinically indicated. Echocardiograms were abnormal in 33 patients. Of these, 7 had other conditions that could cause NHCI. Echocardiography corroborated the clinical diagnosis of a cardiogenic source for cerebral infarction in 17 others. The other 9 had no other clues for cardiovascular disease. Potential etiologies of NHCI diagnosed by echocardiography in these 9 cases included: paradoxical embolism, 5 patients; right atrial myxoma, 1; rheumatic mitral valve vegetation, 1; myxomatous mitral valve (marantic endocarditis at postmortem), 1; and left atrial enlargement associated with decreased left ventricular function, 1. Routine echocardiography frequently conveys useful information in patients under age 45 with NHCI. In young patients with cerebral embolism of unknown etiology if routine M-mode and two dimensional echocardiographic studies are normal, contrast echocardiographic studies should be performed to rule out intracardiac shunts and the possibility of paradoxical cerebral embolism.
我们回顾了15至45岁急性非出血性脑梗死（NHCI）患者的超声心动图检查结果。在132例NHCI患者中，96例（72.7%）接受了M型和二维超声心动图检查，包括在临床需要时进行静脉注射生理盐水的对比超声心动图检查。33例患者的超声心动图异常。其中，7例有其他可能导致NHCI的情况。超声心动图证实另外17例脑梗死的心源性病因诊断。另外9例没有其他心血管疾病线索。这9例经超声心动图诊断的NHCI潜在病因包括：反常栓塞5例；右心房黏液瘤1例；风湿性二尖瓣赘生物1例；黏液样二尖瓣（尸检时为消耗性心内膜炎）1例；左心房扩大伴左心室功能减退1例。常规超声心动图检查常能为45岁以下的NHCI患者提供有用信息。对于病因不明的年轻脑栓塞患者，如果常规M型和二维超声心动图检查正常，应进行对比超声心动图检查以排除心内分流和反常脑栓塞的可能性。
