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首页> 外文期刊>The Internet Journal of Neurology >Time Course of Reversible Cerebral Segmental Vasoconstriction (Call′s Syndrome): Case Report of a 3 Year Follow-up With TCCS
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Time Course of Reversible Cerebral Segmental Vasoconstriction (Call′s Syndrome): Case Report of a 3 Year Follow-up With TCCS

机译：可逆性脑节段性血管收缩的时程（Call综合征）：TCCS 3年随访的病例报告

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A 34 year old woman without a history of migraine experienced acute and severe left-sided throbbing headache followed by remitting periods of right-sided hemiparesis. MRI revealed ischemic stroke of the left lenticulostriate artery (LA). Transcranial color-coded duplexsonography (TCCS) studies and angiography showed cerebral segmental vasoconstriction in different vessels. Therapy with iv heparin, nimodipin and dexamethasone was begun followed by azathioprine over 15 months. There was full and persistant clinical recovery on day 6 after the onset of symptoms. TCCS follow-up showed a slow decline of elevated blood flow velocity (BFV) in both middle cerebral arteries (MCA) over a period of 12 months with persistant normal values over another 2.5 years. Case Report A 34 year old obese woman (92 kg, 155 cm) without a history of migraine suddenly experienced severe left-sided throbbing headache which was followed by a right-sided hemiparesis minutes afterward. She had no history of cigarette smoking, hypertension, hypercholesterinemia, diabetes or of using illicit drugs nor diet pills. CT scan on admission was non-diagnostic. SAH was ruled out by lumbar puncture which was non-diagnostic (4/3 cells, protein 37 mg/dl, IgG 3.25 mg/dl, oligoclonal band neg.). TCCS on admission revealed elevated BFV in both MCA (Fig. 1). Echocardiography and extracranial duplexsonography did not show any signs of atherosclerotic changes and no other abnormalities. IV therapy with heparin and nimodipine was started. During the following hours severity of her hemiparesis varied greatly. On the second hospital day MRI showed ischemic infarction of the left lenticulostriate area. There was full clinical recovery on day 6 after the onset of symptoms despite of persistance of elevated BFVs in both MCA.
机译：一名无偏头痛史的34岁妇女经历了急性和严重的左侧th动性头痛，随后出现了右侧偏瘫的缓解期。 MRI显示左半豆状动脉（LA）缺血性中风。经颅彩色编码双工超声检查（TCCS）和血管造影显示不同血管中的脑节段性血管收缩。开始使用静脉肝素，尼莫地平和地塞米松的治疗，然后在15个月内使用硫唑嘌呤。症状发作后第6天，临床症状全面恢复。 TCCS随访显示，在12个月的时间内，两条大脑中动脉（MCA）的血流速度（BFV）升高缓慢下降，而在另外2.5年内仍保持正常值。病例报告一名无偏头痛史的34岁肥胖妇女（92公斤，155厘米）突然经历严重的左侧搏动性头痛，随后数分钟后出现右侧偏瘫。她没有吸烟，高血压，高胆固醇血症，糖尿病或使用违禁药物或减肥药的病史。入院时进行CT扫描不能诊断。通过非诊断性腰椎穿刺排除了SAH（4/3细胞，蛋白质37 mg / dl，IgG 3.25 mg / dl，寡克隆带阴性）。入院时TCCS显示两个MCA中BFV升高（图1）。超声心动图和颅外超声检查未显示任何动脉粥样硬化改变的迹象，也没有其他异常。开始使用肝素和尼莫地平进行IV治疗。在接下来的几个小时中，她的偏瘫严重程度差异很大。在医院的第二天，MRI显示左半豆状叶区域缺血性梗塞。尽管两个MCA均持续存在BFV升高，但症状发作后第6天已完全恢复临床。

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