烟雾综合征合并双侧大脑后动脉栓塞1例并文献复习  

Moyamoya syndrome complicated with bilateral posterior cerebral artery embolism: a case report and literature review

作　　者：宋良[1] 付胜奇 张淑玲[1] 周俊超 周晓影 禹萌 任雅芳 Song Liang;Fu Shengqi;Zhang Shuling;Zhou Junchao;Zhou Xiaoying;Yu Meng;Ren Yafang(Department of Neurology,the Fifth Clinical Medical College of Henan University of Chinese Medicine(Zhengzhou People′s Hospital),Zhengzhou 450003,China)

机构地区：[1]河南中医药大学第五临床医学院(郑州人民医院)神经内科,郑州450003

出　　处：《中华神经科杂志》2023年第1期75-78,共4页Chinese Journal of Neurology

基　　金：河南省医学科技攻关省部共建项目(SB201903029);河南省医学科技攻关项目(LHGJ20200683)。

摘　　要：烟雾综合征合并双侧大脑后动脉(PCA)栓塞非常罕见, 目前国内没有相关报道。现报道1例烟雾综合征合并双侧PCA栓塞患者, 中年女性, 急性起病, 既往有心房颤动、高血压病、2型糖尿病, 临床表现主要以双眼失明、右侧肢体无力起病, 影像学表现为双侧颞顶枕叶急性脑梗死, 双侧大脑前、中动脉烟雾血管生成, 双侧大脑后动脉闭塞伴远端烟雾血管生成, 结合病史, 病因考虑为不明原因型栓塞。给予积极对症治疗后, 患者意识转清, 肢体无力好转, 但失明未见改善。报道本例患者, 旨在提高临床医师对烟雾综合征患者出现双侧PCA同时栓塞的认识, 有效预防脑梗死的发生。No case of moyamoya syndrome with bilateral posterior cerebral artery(PCA)occlusion has been reported in China so far as this disease is extremely rare.The case shown in this article is a middle-aged women who has a history of atrial fibrillation,hypertension and type 2 diabetes acutely attacked by this syndrome.The main clinical manifestations included binocular blindness,right limb weakness.Imaging findings showed bilateral acute cerebral infarction in the parietal occipital lobe,bilateral anterior cerebral artery and middle cerebral artery smoke angiogenesis,bilateral PCA occlusion with distal smoke angiogenesis.Considering the medical history of the patient,the cause of the disease was diagnosed as embolic stroke of undetermined source.The patient′s consciousness has been recovered and the limb weakness has been improved after active symptomatic treatment.However,the blindness did not see any improvements.This case report aims to improve clinicians′understanding of bilateral PCA embolization in patients with moyamoya syndrome so the occurrence of cerebral infarction can be effectively prevented.

关 键 词：梗死 大脑后动脉 脑底异常血管网病 心房颤动 栓塞 

分 类 号：R743[医药卫生—神经病学与精神病学]