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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Paradoxical Cerebral Embolism as Initial Manifestation of Chronic Thromboembolic Pulmonary Hypertension: A Case Report
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Paradoxical Cerebral Embolism as Initial Manifestation of Chronic Thromboembolic Pulmonary Hypertension: A Case Report

机译：矛盾的脑栓塞作为慢性血栓栓塞肺动脉高压的初始表现：案例报告

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Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by chronic thrombi in the pulmonary arteries, causing pulmonary hypertension and right heart failure. Early and accurate diagnosis are essential for successful treatment but are often difficult because clinical signs and symptoms can be nonspecific and risk factors, such as history of venous thromboembolism, may not always be present. Here, we report a case involving a 76-year-old woman who demonstrated paradoxical cerebral embolism as the initial manifestation of CTEPH. She developed right hemiplegia without dyspnea or edema. Brain magnetic resonance imaging revealed multiple fresh infarctions, while transesophageal echocardiography revealed a patent foramen ovale. Based on these findings, she was diagnosed as having paradoxical cerebral embolism. During the search for the embolic source, right heart catheterization showed significant pulmonary hypertension and pulmonary angiography revealed chronic thrombi in the peripheral pulmonary arteries, consistent with a diagnosis of CTEPH. To our knowledge, this is the first case of CTEPH to be diagnosed with the onset of paradoxical cerebral embolism. Because CTEPH is the only potentially curable form of pulmonary hypertension, clinicians should consider paradoxical cerebral embolism as a possible initial manifestation of CTEPH.
机译：慢性血栓栓塞肺动脉高压（CTEPH）的特征在于肺动脉中的慢性血栓，引起肺动脉高压和右心力衰竭。早期准确的诊断对于成功治疗至关重要，但往往是难以的，因为临床症状和症状可以是非特异性的，并且危险因素，如静脉血栓栓塞的历史，可能并不总是存在。在这里，我们举报了一个涉及一个76岁女性的案例，他们展示了矛盾的脑栓塞作为CTeph的初始表现。没有呼吸困难或水肿，她开发出正确的偏瘫。脑磁共振成像显示出多种新鲜梗塞，而经疗超声心动图揭示了专利诱饵卵形。基于这些发现，她被诊断为具有矛盾的脑栓塞。在寻找栓塞源，右心导管插入率显示出显着的肺动脉高压和肺血管造影显示在外周肺动脉中的慢性血栓，与CTEPH的诊断一致。据我们所知，这是第一种被诊断患有矛盾的脑栓塞发作的CTEPH的案例。因为CTEPH是唯一可能的肺动脉高压的潜在可固化形式，所以临床医生应考虑矛盾的脑栓塞作为CTEPH可能的初始表现。

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