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首页> 外文期刊>eNeurologicalSci >Recurrent thrombolysis of a stuttering lacunar infarction captured on serial MRIs
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Recurrent thrombolysis of a stuttering lacunar infarction captured on serial MRIs

机译：连续MRI捕获的口吃性腔隙性梗死的复发性溶栓

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摘要

Lacunar strokes account for about a fourth of all ischemic strokes. Pontine infarcts often present with stuttering symptoms, referred to as pontine warning syndrome (PWS). Patients presenting with fluctuating symptoms can appear to have rapidly improving symptoms and thus often go untreated despite the risk of recurrent deficits. MRI carries a higher sensitivity in detecting posterior circulation strokes compared to computed topagraphy, but does not always indicate irreversible injury. Here we present the first description of a stuttering lacune, captured radiographically on serial magnetic resonance imaging (MRI), that was initially averted with the administration of intravenous (IV) tissue plasminogen activator (tPA), only to return a month later and progress on imaging despite re-administration of tPA. During the first admission, our patient had spontaneous resolution of symptoms with complete reversal on restricted diffusion soon after IV tPA administration. On the second admission, the stuttering symptoms returned as did the same pontine lesion. Although his stuttering lesions lasted for several days, and the pontine lesion did ultimately progress to partial infarction on MRI, he was discharged home without neurologic deficits. Our case suggests that tPA may be of benefit in patients with lacunar pontine strokes even if symptoms rapidly improve or resolve.
机译：腔隙性卒中约占所有缺血性卒中的四分之一。桥脑梗死常表现为口吃症状，称为桥脑警告综合征（PWS）。表现为波动症状的患者似乎可以迅速改善症状，因此尽管有反复出现赤字的风险，但经常不予治疗。与计算机体层摄影相比，MRI在检测后循环中风方面具有更高的灵敏度，但并不总是表明不可逆损伤。在这里，我们介绍了对口吃的腔室的首次描述，该腔室是在连续磁共振成像（MRI）上通过射线照相术捕获的，最初是通过静脉内（IV）组织纤溶酶原激活剂（tPA）施用而避免的，仅在一个月后返回并继续治疗尽管重新给予了tPA，仍进行了影像学检查。在首次入院期间，我们的患者在静脉内给予tPA后不久就出现了症状的自发缓解，并在受限扩散下完全逆转。第二次入院时，口吃症状恢复了，同样的桥脑病变也恢复了。尽管他的口吃病变持续了数天，并且脑桥病变最终在MRI上最终发展为部分梗塞，但他出院后没有神经功能缺损。我们的案例表明，tPA对腔隙性脑桥卒中患者可能有益，即使症状迅速改善或缓解。

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