经导管溶栓治疗小儿大动脉炎合并急性脑梗死：一例报告
Transcatheter thrombolysis in children with Takayasu's arteritis complicated by acute cerebral infarction: a case report.
作者信息
Ding Li-Shan, Liang Hao, Zheng Ming, Shen Meng, Li Zhao-Jun, Chen Qing-Liang
机构信息
Department of Hemato-Oncology, The First Affiliated Hospital of Henan University of Chinese Medicine Zhengzhou 450099, Henan, China.
Department of Radioactive Intervention, Henan No. 3 Provincial People's Hospital Zhengzhou 450006, Henan, China.
出版信息
Am J Transl Res. 2024 Nov 15;16(11):6828-6834. doi: 10.62347/ZFIM7208. eCollection 2024.
BACKGROUND
Takayasu arteritis (TA), a rare systemic macrovasculitis in children, affects multiple arteries, causing necrosis, remodeling, stenosis, or dilatation. Due to nonspecific symptoms, early diagnosis is challenging, and it is often missed until organ dysfunction occurs. TA poses a significant health threat, with few reports on acute cerebral infarction in pediatric cases.
CASE PRESENTATION
An 11-year-old girl presented with TA-induced thrombosis in the right middle cerebral artery's upper trunk. Despite prompt thrombolysis restoring blood flow, brain tissue necrosis and dysfunction persisted. Pre-intervention MRA showed occlusion and stenosis in relevant arteries. Subsequent angiography confirmed multiple-artery acute stroke, supported by imaging, serology, and cerebrospinal fluid tests. Timely rehabilitation, hormone treatment, and early diagnosis led to a favorable outcome.
CONCLUSIONS
Early diagnosis and treatment of pediatric TA are crucial to prevent organ damage. Transcatheter thrombolysis effectively restores brain perfusion in acute infarction cases.
背景
大动脉炎（TA）是一种儿童罕见的系统性大血管炎，累及多条动脉，可导致坏死、重塑、狭窄或扩张。由于症状不具特异性，早期诊断具有挑战性，常在出现器官功能障碍之前被漏诊。TA对健康构成重大威胁，儿科病例中急性脑梗死的报道较少。
病例介绍
一名11岁女孩出现由TA引起的右大脑中动脉上干血栓形成。尽管及时进行溶栓恢复了血流，但脑组织坏死和功能障碍仍然存在。干预前的磁共振血管造影（MRA）显示相关动脉闭塞和狭窄。随后的血管造影证实为多动脉急性卒中，影像学、血清学和脑脊液检查均予以支持。及时的康复治疗、激素治疗以及早期诊断带来了良好的结果。
结论
儿科TA的早期诊断和治疗对于预防器官损害至关重要。经导管溶栓可有效恢复急性梗死病例的脑灌注。
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