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本月病例:1997年7月——患有短暂性脑缺血发作的糖尿病男性。

Case of the month: July 1997--diabetic male with transient ischemic attacks.

作者信息

Karpinsky N C, Powell H

机构信息

Department of Pathology, US Department of Veteran's Affairs Medical Center, La Jolla, CA.

出版信息

Brain Pathol. 1998 Jan;8(1):235-6.

PMID:9458181
Abstract

A 60-year-old diabetic male presented with transient ischemic attacks. Initial neurological examination and head CT were normal. Dysarthria, ataxia, delirium, and lethargy developed. A diagnosis of cryptococcal meningitis was made after lumbar puncture and treatment with intravenous amphotericin B and 5-fluorcytosine was begun. A repeat head CT showed an anterior cerebral artery territory infarct. His condition worsened and he died of associated complications three weeks after admission. The case is used to discuss the association between cryptococcal meningitis and diabetes, transient ischemic attacks, and vasculitis with cerebral infarction.

摘要

一名60岁的男性糖尿病患者出现短暂性脑缺血发作。初始神经系统检查及头部CT均正常。随后出现构音障碍、共济失调、谵妄及嗜睡。腰椎穿刺后诊断为新型隐球菌脑膜炎,并开始静脉应用两性霉素B及5-氟胞嘧啶治疗。复查头部CT显示大脑前动脉供血区梗死。其病情恶化,入院三周后死于相关并发症。该病例用于讨论新型隐球菌脑膜炎与糖尿病、短暂性脑缺血发作以及伴脑梗死的血管炎之间的关联。

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