Fujishima S, Okada Y, Irie K, Kitazono T, Saku Y, Utsunomiya H, Sugihara S, Sadoshima S, Fujishima M
Department of Cerebrovascular Disease, St. Mary's Hospital, Kurume, Japan.
Angiology. 1994 Feb;45(2):161-6. doi: 10.1177/000331979404500213.
A fifty-four-year-old woman died from multiple brain infarction and hemorrhage in the bilateral cerebrum, cerebellum, and brainstem, with renal infarction. She developed hematuria and transient blindness sixteen days before admission. Low-grade fever, heart murmur, and aortic valve vegetation on ultrasonic cardiography suggested infectious endocarditis. Autopsy study revealed occult adenocarcinoma in the lung and nonbacterial thrombotic endocarditis, but infective endocarditis was not histologically confirmed. The patient was considered to be a rare case of nonbacterial thrombotic endocarditis who developed multiple small infarctions mainly in the brainstem and cerebellum. Nonbacterial thrombotic endocarditis seems to be still an important disease as the embolic source, even if cryptic, of systemic thromboembolism.
一名54岁女性死于双侧大脑、小脑和脑干的多发性脑梗死及出血，并伴有肾梗死。入院前16天，她出现了血尿和短暂失明。低热、心脏杂音以及超声心动图显示的主动脉瓣赘生物提示感染性心内膜炎。尸检研究发现肺部隐匿性腺癌和非细菌性血栓性心内膜炎，但组织学上未证实感染性心内膜炎。该患者被认为是罕见的非细菌性血栓性心内膜炎病例，主要在脑干和小脑发生了多发性小梗死。非细菌性血栓性心内膜炎似乎仍是一种重要疾病，即使隐匿，也是全身性血栓栓塞的栓子来源。
