特鲁索综合征致急性多发性脑梗死4例(附文献复习)  

Trousseau’s syndrome performed as acute multiple cerebral infarction:four cases report and literature review

作　　者：王璐[1] 秦姝竹 张佩瑶[2] 王康[1] 金淼[1] WANG Lu;QIN Shu-zhu;ZHANG Pei-yao

机构地区：[1]中日友好医院神经内科,北京100029 [2]中日友好医院放射诊断科,北京100029

出　　处：《中日友好医院学报》2021年第6期332-335,F0002,共5页Journal of China-Japan Friendship Hospital

摘　　要：目的:分析以急性多发性脑梗死为主要表现的特鲁索(Trousseau)综合征的临床及影像学特征。方法:回顾分析2019年6月~2020年12月中日友好医院神经内科收治的4例以急性多发性脑梗死为表现的Trousseau综合征患者的临床资料,并结合文献报道分析该病临床和影像特征。结果:4例患者中男3例,女1例;发病年龄62~79岁;均患肺腺癌。2例病程中再发脑梗死;3例患者D-二聚体明显升高;颅脑MRI均表现急性多发性脑梗死,其中2例伴脑转移瘤、3例脑外转移;2例伴有静脉系统血栓;3例予低分子肝素抗凝治疗。结论:急性多发性脑梗死是Trousseau综合征的一种表现,对于不符合单支动脉供血区的急性多发性脑梗死,病因需考虑恶性肿瘤所致高凝状态;肿瘤晚期患者易并发Trousseau综合征。Objective:To analyze the clinical and imaging features of Trousseau’s syndrome performed as acute multiple cerebralinfarction.Methods:From June 2019 to December 2020,4 Trousseau’s syndrome patients performed as acute multiple cerebral infarction were selected in the Department of Neurology of China-Japan Friendship Hospital.Their clinical data were retrospectively analyzed,and pertinent literatures were reviewed to analyze the clinical features of Trousseau’s syndrome performed as acute multiple cerebral infarction.Results:Of the 4 patients,3 were males and the other was a female;of onset ranged from 62 to 79 years old;all of them were diagnosed as lung adenocarcinomas;2 cases were initially attacked bycerebral infarction,2 cases encountered the second attack.D-Dimer(D-D)level was significantly increased in 3 patients.Craniocerebral MRI of all of the 4 patients showed multiple cerebral infarction,2 cases with intracranial metastasis and 2 with extracerebral metastasis.Venous thrombosis were found in 2 patients.Of the 4 patients,3 cases received anticoagulant therapy of low molecular weight heparin.Conclusion:Acute multiple cerebral infarction may be one of manifestations of Trousseau’s syndrome.Thus malignant tumor should be considered as the cause of high coagulation state,especially in the patients with subtypical single-artery blood supply area lesion.Patients with advanced cancer are at high risk for Trousseau’s syndrome.

关 键 词：血栓栓塞 特鲁索综合征 脑梗死 癌 

分 类 号：R743.3[医药卫生—神经病学与精神病学]