论文部分内容阅读
报告1例基底动脉与小脑前动脉巨细胞动脉炎引起的小脑梗塞。患者女,85岁,因突然右侧头痛伴恶心、呕吐与一过性共济失调2周入院。既往有房颤、高血压、乳腺癌乳房切除史。体检:闻及喷射性收缩期杂音,周围血管搏动可触及。一侧注视时出现水平眼震,右视时尤为明显。辨距不能、右臂轮替运动障碍,步态蹒跚向右倾以致行走不能。血小板轻度升高,ESR 明显加快。CT 示基底节钙化。入院后病情迅速恶化,5天后死亡。尸检示右小脑半球上外侧软化,矢状切面见右小脑前下动脉(AICA)的分布区域可见灰白质界限不清的楔形软化灶。组织学检查见基底动脉与右 AICA 呈节段性巨细胞动脉炎(GCA)改变,内膜与中层有多核巨细胞浸
Report of 1 cases of basilar artery and cerebellar infarction caused by giant cell arteritis of cerebellar artery. Female, 85 years old, admitted to hospital with a sudden right sided headache with nausea, vomiting and transient ataxia for 2 weeks. Past history of atrial fibrillation, high blood pressure, breast cancer mastectomy. Physical examination: smell and jet systolic murmur, peripheral vascular beats can be touched. Side of the eye when nystagmus level, especially when the right eye. Can not distinguish between the right arm rotation disorder, gait staggered to the right so that the result can not walk. Slightly elevated platelets, ESR significantly accelerated. CT showed basal ganglia calcification. The condition deteriorated rapidly after admission and died after 5 days. An autopsy showed the lateral softening of the right cerebellar hemisphere, and the sagittal section of the right anterior inferior cerebellar artery (AICA) showed a wedge-shaped softened foci with unclear gray matter. Histological examination of basilar artery and right AICA showed segmental giant cell arteritis (GCA) changes, intima and middle multinucleated giant cell immersion