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酷似脊髓梗死的急性勒里什综合征:一例报告

Acute Leriche Syndrome Mimicking Spinal Cord Infarction: A Case Report.

作者信息

Kanbayashi Takamichi, Tanaka Sonoko, Matsukura Kiyoshi, Sonoo Masahiro, Kobayashi Shunsuke

机构信息

Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan.

出版信息

Case Rep Neurol. 2024 May 24;16(1):148-153. doi: 10.1159/000539456. eCollection 2024 Jan-Dec.

Abstract

INTRODUCTION

Acute Leriche syndrome is a rare but potentially life-threatening condition. Pain, pallor, and coldness of the lower extremities serve as clues for suspecting Leriche syndrome. However, the absence of these findings may pose a diagnostic challenge.

CASE PRESENTATION

An 83-year-old man presented at our emergency department with a complaint of sudden-onset paraparesis. Initially, spinal cord infarction was suspected due to clinical course and neurological findings, but thoracolumbar MRI showed normal findings. On admission, symptoms associated with aortoiliac occlusion were not present, except for muscle atrophy in the thigh. CT angiography revealed aortoiliac occlusion, leading to a diagnosis of Leriche syndrome.

CONCLUSION

Leriche syndrome should be considered as a potential differential diagnosis in patients with acute paraparesis. Muscle atrophy of the lower limbs disproportionate to the clinical course may be the clue for suspecting acute Leriche syndrome with symptoms related to atherosclerotic occlusion which are inconspicuous.

摘要

引言

急性勒里什综合征是一种罕见但可能危及生命的病症。下肢疼痛、苍白和发冷是怀疑勒里什综合征的线索。然而,缺乏这些表现可能会带来诊断挑战。

病例介绍

一名83岁男性因突发双下肢轻瘫到我院急诊科就诊。最初,由于临床病程和神经学检查结果怀疑为脊髓梗死,但胸腰椎磁共振成像显示结果正常。入院时,除大腿肌肉萎缩外,不存在与主-髂动脉闭塞相关的症状。CT血管造影显示主-髂动脉闭塞,从而诊断为勒里什综合征。

结论

对于急性双下肢轻瘫患者,应考虑勒里什综合征作为潜在的鉴别诊断。与临床病程不相称的下肢肌肉萎缩可能是怀疑急性勒里什综合征的线索,其与动脉粥样硬化闭塞相关的症状不明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43af/11250112/6cf2d6b514ea/crn-2024-0016-0001-539456_F01.jpg

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