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大脑中动脉(MCA)狭窄在西方人群中很少见,为脑卒中频繁复发的高危因素。目前认为,MCA狭窄患者脑卒中的发病机理为动脉至动脉栓子形成所致。Nabavi等发现,仅14％MCA狭窄患者能够检测到狭窄后段微栓子信号(MES),而未经抗凝治疗的脑卒中急性期患者均能检测到。Sliwka等发现,在已接受不同治疗的慢性MCA狭窄患者中均未检测到MES。作者报道一例MCA狭窄患者短暂性脑缺血(TIA)频繁发作时MCA狭窄后段一组新的MES群。 患者为男性,75岁,因突起左下肢轻瘫入院。起病前有三次一过性感觉异常,两次发生在同一部位,每次持续30分钟。既往有高血压及轻度高胆固醇血症。入院时神清语利,颅神经检查正常,左下肢轻瘫,左侧巴氏
Middle cerebral artery (MCA) stenosis is rare in Western populations and is a risk factor for frequent recurrent stroke. Currently, the pathogenesis of stroke in patients with MCA is due to arterial to arterial embolism. Nabavi et al found that only 14% of patients with stenosed MCA were able to detect a stenotic posterior segment of micro-embolus signal (MES), whereas patients without an anticoagulant stroke at acute stage were able to detect it. Sliwka et al found no detectable MES in patients with chronic MCA who had undergone different treatments. The authors report a new group of MES in the posterior segment of MCA with frequent episodes of transient ischemic attack (TIA) in a patient with MCA stenosis. The patient was a male, 75 years old, admitted to hospital with a left lower extremity paresis. There are three times before onset of a transient sensory abnormalities occurred twice in the same place, each time for 30 minutes. Past high blood pressure and mild hypercholesterolemia. Admission Qingliang Lee, cranial nerve examination was normal, left paraplegia, left paste