...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Fatal multiple systemic emboli after intravenous thrombolysis for cardioembolic stroke
【24h】

Fatal multiple systemic emboli after intravenous thrombolysis for cardioembolic stroke

机译：心脏溶栓性脑卒中静脉溶栓后致命的多系统性栓子

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Our objective is to present a case of fatal multiple systemic emboli after intravenous thrombolysis for cardioembolic stroke. A 64-year-old woman with atrial fibrillation was admitted for evaluation of sudden consciousness disturbance, right hemiplegia, and aphasia. Diffusion-weighted imaging showed no early ischemic changes of the brain, and magnetic resonance angiography (MRA) showed occlusion of the left middle cerebral artery (MCA). One hour after initiation of 0.6 mg/kg of intravenous alteplase, the MCA was partially recanalized. Her symptoms disappeared the following day. We began intravenous heparin for secondary prevention of cardioembolic stroke. However, on the third day (52 hours after thrombolysis), she suddenly developed a coma and left hemiplegia. MRA showed acute occlusion of the right internal carotid artery (ICA). She developed acute kidney injury and sudden shock and then died of fatal cardiorespiratory arrest on the fourth day. Autopsy revealed occlusion of the mitral valve orifice by a spherical fresh red thrombus that led from the left atrial appendage. Acute embolic infarcts were identified in the spleen and right kidney, the latter secondary to occlusion of the right renal artery with fresh red thrombus. Intravenous thrombolysis and subsequent anticoagulation therapy may destabilize pre-existing intracardiac thrombus, potentially leading to recurrent stroke, multiple systemic embolisms, and the fatal "hole-in-one" effect.
机译：我们的目的是为心脏栓塞性卒中静脉溶栓治疗后呈现致命的多系统性栓塞病例。一名64岁患有房颤的妇女因评估突然的意识障碍，右偏瘫和失语症而入院。扩散加权成像未见大脑的早期缺血性改变，磁共振血管造影（MRA）显示左大脑中动脉（MCA）阻塞。在开始使用0.6 mg / kg的阿替普酶静脉注射一小时后，将MCA进行部分再通。第二天她的症状消失了。我们开始静脉注射肝素，以预防心脏栓塞性中风。但是，在第三天（溶栓后52小时），她突然出现昏迷并出现了偏瘫。 MRA显示右颈内动脉（ICA）急性阻塞。她患有急性肾损伤和突然电击，然后在第四天因致命的心肺骤停而死亡。尸检显示二尖瓣口被球形新鲜红色血栓阻塞，该血栓由左心耳引出。在脾脏和右肾中发现了急性栓塞性梗塞，后者是继发于右肾动脉并伴有新鲜的红色血栓而继发的。静脉溶栓和随后的抗凝治疗可能会使先前存在的心内血栓不稳定，可能导致卒中复发，多发性全身性栓塞和致命的“多合一”效应。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号