Marcolini F, Arnone G, Weston C, Tempia Valenta S, Zini A, De Ronchi D, Atti A R
Department of Biomedical and Neuromotor Sciences, University of Bologna, Viale Pepoli 5, 40123, Bologna, Italy.
IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurologia e Rete Stroke metropolitana Ospedale Maggiore, Bologna, Italy.
J Eat Disord. 2024 Aug 6;12(1):111. doi: 10.1186/s40337-024-01074-0.
Anorexia Nervosa (AN) is a complex psychiatric illness, characterized by a high risk of developing cardiovascular complications. Given the high risk of vascular diseases in patients with AN, we can assume that patients with severe AN have a high risk of developing ischemic stroke. However, to the best of our knowledge, no reports of patients with AN presenting with ischemic stroke have been published, other than a report of the development of IS during refeeding therapy in patients with severe AN.
The present case report is aimed at describing the characteristics of an ischemic stroke occurring in a 19-year-old university student who had a 6-month history of AN. She was a non-smoker, had no relevant medical history and no family history of stroke. Upon hospital admission due to symptoms of stroke (aphasia and facial droop), she exhibited severe malnutrition with a BMI of 12.8 kg/m. Computerized tomography imaging revealed occlusion of the left M2 branch and a congruous extensive area of hypoperfusion. Further investigations ruled out all common causes of stroke: she had no vascular stenosis, no heart diseases or arrhythmias, and no shunts, and gave negative results in autoimmune, toxicological and thrombophilia screenings.
Clinicians should suspect development of severe complications, including ischemic stroke, in patients with severe AN. Further extensive group studies or group-based studies are needed to elucidate the etiology of ischemic stroke in patients with severe AN. This will enable us to develop more precise and effective interventions.
神经性厌食症（AN）是一种复杂的精神疾病，其特征是发生心血管并发症的风险很高。鉴于AN患者患血管疾病的风险很高，我们可以假设重度AN患者发生缺血性中风的风险也很高。然而，据我们所知，除了一篇关于重度AN患者在重新进食治疗期间发生缺血性中风的报道外，尚未有关于AN患者出现缺血性中风的报道。
本病例报告旨在描述一名患有6个月AN病史的19岁大学生发生缺血性中风的特征。她不吸烟，无相关病史，也无中风家族史。因中风症状（失语和面部下垂）入院时，她表现出严重营养不良，体重指数为12.8kg/m。计算机断层扫描成像显示左M2分支闭塞以及相应的广泛灌注不足区域。进一步检查排除了所有常见的中风原因：她没有血管狭窄、没有心脏病或心律失常、没有分流，自身免疫、毒理学和血栓形成倾向筛查结果均为阴性。
临床医生应怀疑重度AN患者会发生包括缺血性中风在内的严重并发症。需要进一步进行广泛的队列研究或基于群体的研究，以阐明重度AN患者缺血性中风的病因。这将使我们能够制定更精确有效的干预措施。
