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[1例脑栓塞后早期接受手术治疗的左心房黏液瘤]

[A case of surgically treated left atrial myxoma early after cerebral embolism].

作者信息

Ota T, Okumura S, Matsuba K, Yamashita M, Ushimaru K

机构信息

Department of Cardiovascular Surgery, Mimihara General Hospital, Sakai, Japan.

出版信息

Kyobu Geka. 1996 Dec;49(13):1094-6.

PMID:8958685
Abstract

A 48-year-old female had been visiting the outpatient clinic for treatment of polyarthritis before she was admitted to the hospital due to consciousness disorder and right hemiplegia. Brain computed tomography revealed a small infarction in the left cerebrum. Echocardiography revealed a mass in the left atrium. She was diagnosed cerebral embolism caused by left atrial myxoma. Extirpation of left atrial myxoma was performed 16 days after the onset of cerebral infarction. The postoperative course was good. Preoperative constitutional signs such as multiple arthralgia and abnormal sensation disappeared on the 2nd postoperative day. Open heart surgery performed early after the onset of cerebral embolism is generally considered contraindicated due to problems of hemorrhagic infarction or brain edema. Because relapse of embolism may deteriorate the condition, losing the chance of surgery, extirpation of left atrial myxoma early after the onset of cerebral infarction is advisable in cases of small infarction.

摘要

一名48岁女性在因意识障碍和右侧偏瘫入院前一直在门诊治疗多关节炎。脑部计算机断层扫描显示左脑有一个小梗死灶。超声心动图显示左心房有一个肿块。她被诊断为左心房黏液瘤引起的脑栓塞。在脑梗死发病16天后进行了左心房黏液瘤切除术。术后病程良好。术前的全身性体征如多关节痛和感觉异常在术后第2天消失。由于出血性梗死或脑水肿问题,脑栓塞发病后早期进行心脏直视手术通常被认为是禁忌的。因为栓塞复发可能使病情恶化,失去手术机会,所以在小梗死病例中,脑梗死发病后早期切除左心房黏液瘤是可取的。

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