Yoshida S, Yamamoto T, Oda Y, Kawakami Y, Ban S, Sato S, Matsumoto S, Nakazawa K
Department of Neurologery, Kobe City General Hospital.
No Shinkei Geka. 1996 Apr;24(4):347-50.
We reported a case of juvenile cerebral infarction following minor head injury. The patient, a 12-year-old girl, developed right hemiparesis and aphasia almost immediately after having fallen from about 1 meter height during the exercise class at school. CT and MRI study showed lacunar lesions bilaterally and almost symmetrically in the paraventricular deep white matter on both sides. A new stroke area, responsible for the symptoms, was recognized about 24 hours later on CT scan just next to the lacuna of the left side. Although angiography revealed a rare anomaly of the right side aortic arch, associated with subclavian steal phenomenon, presumably of congenital in nature, no abnormality was found in the intracranial vessels. She made a rapid recovery during her hospital stay and showed no more than a slight motor weakness in her right upper extremity on discharge. The literature was reviewed on the embryology of the aortic arch and brachiocephalic arteries. We speculate that the lacunar lesions found bilaterally are dilated large normal Virchow-Robin space, and the pathogenesis of the stroke in this patient was discussed.
我们报告了一例轻微头部损伤后发生的青少年脑梗死病例。该患者为一名12岁女孩，在学校体育课上从约1米高处跌落之后几乎立即出现了右侧偏瘫和失语症。CT和MRI检查显示双侧脑室旁深部白质有腔隙性病变，且两侧几乎对称。大约24小时后，在CT扫描中于左侧腔隙紧邻处发现了一个导致症状的新卒中区域。尽管血管造影显示右侧主动脉弓存在罕见异常，并伴有锁骨下动脉盗血现象，推测为先天性，但颅内血管未发现异常。她在住院期间恢复迅速，出院时仅右侧上肢有轻微运动无力。我们回顾了关于主动脉弓和头臂动脉胚胎学的文献。我们推测双侧发现的腔隙性病变是扩张的大的正常Virchow-Robin间隙，并讨论了该患者卒中的发病机制。
