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经取栓术取出栓子确诊的主动脉源性钙化性脑栓塞:病例说明

Aortogenic calcified cerebral embolism diagnosed with an embolus retrieved by thrombectomy: illustrative case.

作者信息

Yokochi Yasunori, Ikeda Hiroyuki, Tanimura Mai, Osuki Takuya, Uezato Minami, Kinosada Masanori, Kurosaki Yoshitaka, Chin Masaki

机构信息

Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan

出版信息

J Neurosurg Case Lessons. 2024 Apr 1;7(14). doi: 10.3171/CASE2499.

Abstract

BACKGROUND

Calcified cerebral embolism has been reported as a cause of acute cerebral infarction, but an aortogenic origin has rarely been identified as the embolic source. The authors describe a case of aortogenic calcified cerebral embolism in a patient with other embolic sources.

OBSERVATIONS

In a patient with cerebral infarction and atrial fibrillation, a white hard embolus was retrieved by mechanical thrombectomy. Pathological analysis of the embolus revealed that it was mostly calcified, with some foam cells and giant cells. The macroscopic and pathological findings allowed the authors to finally diagnose an aortogenic calcified cerebral embolism.

LESSONS

Even in patients with cardiogenic embolic sources, it is possible to identify a complex aortic atheroma with calcification as the embolic source, based on the macroscopic and pathological findings of the embolus retrieved by mechanical thrombectomy.

摘要

背景

钙化性脑栓塞已被报道为急性脑梗死的一个病因,但很少有以主动脉源性作为栓子来源的情况被发现。作者描述了一例患有其他栓子来源的患者发生主动脉源性钙化性脑栓塞的病例。

观察结果

在一名患有脑梗死和心房颤动的患者中,通过机械取栓术取出了一个白色坚硬的栓子。对该栓子进行病理分析发现,其大部分为钙化,伴有一些泡沫细胞和巨细胞。宏观和病理检查结果使作者最终诊断为主动脉源性钙化性脑栓塞。

经验教训

即使在有心源性栓子来源的患者中,根据通过机械取栓术取出的栓子的宏观和病理检查结果,也有可能识别出伴有钙化的复杂主动脉粥样硬化斑块作为栓子来源。

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