Okata Takuya, Yoshioka Tsutomu, Wakisaka Yoshinobu, Ago Tetsuro, Ogata Toshiyasu, Kitayama Jiro
Department of Neurology, Japanese Red Cross Fukuoka Hospital.
Department of Neurosurgery, Japanese Red Cross Fukuoka Hospital.
Rinsho Shinkeigaku. 2023 Sep 20;63(9):577-581. doi: 10.5692/clinicalneurol.cn-001872. Epub 2023 Aug 29.
We present a case of a 41-year-old female presenting with recurrence of ischemic stroke on subtherapeutic doses of dabigatran. She had a history of embolic stroke of undetermined sources at the age of 40, and underwent implantable cardiac monitor implantation and had started dabigatran. One year after the first ischemic stroke, she presented with sudden dysarthria and left hemiparesis and was admitted to our hospital. An MRI of the head revealed acute cerebral infarction in the right corona radiata, and an MR angiography revealed right M2 occlusion. Cervical 3D-CTA revealed a protruding structure on the posterior wall of the carotid artery bulb, which was diagnosed as carotid web. She underwent carotid endarterectomy, and the specimen was pathologically confirmed to be vascular malformation due to fibromuscular dysplasia.
我们报告一例41岁女性病例，该患者在服用低于治疗剂量的达比加群时出现缺血性中风复发。她在40岁时有不明来源的栓塞性中风病史，接受了植入式心脏监测器植入并开始服用达比加群。首次缺血性中风一年后，她出现突发构音障碍和左侧偏瘫，并入住我院。头部MRI显示右侧放射冠急性脑梗死，磁共振血管造影显示右侧M2闭塞。颈部3D-CTA显示颈动脉球后壁有一突出结构，诊断为颈动脉蹼。她接受了颈动脉内膜切除术，病理证实标本为纤维肌发育不良所致的血管畸形。
