Miyamoto T, Tarukawa Y, Katayama S, Sato M, Shimizu S, Homma M, Watanabe K, Miyamoto M, Hirata K
Department of Neurology, Southern Tohoku Research Institute for Neuroscience, Fukushima, Japan.
No To Shinkei. 1997 Oct;49(10):919-23.
A 43-year-old woman was admitted into our hospital because of aphasia and right hemiparesis. Computed tomographic scan demonstrated border zone infarction in the anterior and middle cerebral artery. Magnetic resonance imaging scans showed the borderline area between the terminal branches of the lenticulostriate arteries and the perforating branches of the middle cerebral artery. Digital subtraction ICA angiogram showed severe narrowing of the distal portion of the right and left ICA. A pattern analysis of ambulatory blood pressure monitoring (ABPM) was carried out in this patient, and it was showed "dipper type". Laboratory data was elevated excretion of pituitary gonadotropines and low estrogen excretion. Chromosome analysis revealed the 45, X/46, XX. She was diagnosed with mosaic type of Turner's syndrome. The cerebrovascular abnormality might be due to congenital hypoplasia of arteries, and declining of blood pressure during sleep was possible significant factors in the pathogenesis of cerebral infarction in this patient.
一名43岁女性因失语和右侧偏瘫入院。计算机断层扫描显示大脑前动脉和中动脉交界区梗死。磁共振成像扫描显示豆纹动脉终末分支与大脑中动脉穿支之间的交界区。数字减影ICA血管造影显示左右ICA远端严重狭窄。对该患者进行了动态血压监测(ABPM)模式分析,结果显示为“勺型”。实验室数据显示垂体促性腺激素排泄增加而雌激素排泄减少。染色体分析显示为45,X/46,XX。她被诊断为嵌合型特纳综合征。脑血管异常可能是由于动脉先天性发育不全,睡眠期间血压下降可能是该患者脑梗死发病机制中的重要因素。