Ekpendu Abuoma C, Prakash Puneet, Brands Chad K
Internal Medicine, AdventHealth Sebring, Sebring, Florida, USA.
Ann Med Surg (Lond). 2025 Jan 31;87(2):998-1001. doi: 10.1097/MS9.0000000000002780. eCollection 2025 Feb.
Beyond the familiar face of the acute ischemic stroke, lies the unexpected display of symptoms challenging our preconceptions and beckoning us to explore the intriguing nuances that lie beneath the surface.
We introduce an unusual case of an older adult who presented to our institution with repetitive focal neurologic deficits (FND). Initial investigation was negative for any brain hemorrhage or infarcts. Repeat investigation during readmission showed findings of brain infarct for which appropriate treatment was provided. The fluctuating pattern of FND is what we refer to as a stuttering presentation of stroke.
Our case brings attention to stuttering, an atypical presentation of ischemic stroke, not previously well described in medical literature. Our case demonstrates that stuttering stroke presentations may imitate more short-lived neurologic events such as transient ischemic attacks.
All the patient events throughout the entirety of their time course should be thoroughly reviewed so that thrombolytics can then be considered in the earliest window of opportunity for patients with stuttering stroke presentations to prevent disability due to ischemic stroke.
在急性缺血性中风常见症状之外,还存在一些意想不到的症状表现,这些症状挑战着我们的先入之见,并促使我们去探索其表面之下有趣的细微差别。
我们介绍一位老年患者的不寻常病例,该患者因反复出现局灶性神经功能缺损(FND)前来我院就诊。初步检查未发现任何脑出血或梗死。再次入院时的复查显示有脑梗死迹象,并给予了适当治疗。FND的波动模式就是我们所说的中风的口吃样表现。
我们的病例引起了人们对口吃样表现的关注,这是缺血性中风的一种非典型表现,此前在医学文献中描述不多。我们的病例表明,口吃样中风表现可能会模仿一些持续时间较短的神经事件,如短暂性脑缺血发作。
应全面回顾患者整个病程中的所有事件,以便在口吃样中风表现的患者最早的机会窗口考虑使用溶栓药物,以预防缺血性中风导致的残疾。