Neurology:累及平滑肌细胞收缩功能的遗传性血管病

2018-02-17 杨中华 脑血管病及重症文献导读

2岁,女孩,父母非近亲结婚。因右侧偏瘫和失语就诊。

2岁,女孩,父母非近亲结婚。

因右侧偏瘫和失语就诊。

脑MRI显示左侧ACA/MCA分布区新发梗死,右侧ACA/MCA分布区陈旧性梗死。

DSA显示双侧颈内动脉末端和MCA狭窄,侧枝建立,符合Moyamoya动脉病的表现(下图A-C)。

下图A和B分别为右侧和左侧ICA造影,显示ICA末端狭窄,双侧MCA M1段和ACA A1段连续长节段狭窄(两个箭头之间),并见烟雾样血管。图C为左侧ICA显示烟雾样血管(箭头):



主动脉中部和双侧肾动脉狭窄(图G)。超声心动图显示动脉导管未闭。

4年后DSA显示右侧MCA M1段血管狭窄加重(D图),左侧ICA末端闭塞(图E和F),烟雾样血管增加(图F)。双侧肾动脉狭窄(图G):



全基因组测序显示MYH11基因杂合突变,首次发现该基因突变与Moyamoya样血管病有关。

下表,平滑肌细胞收缩(SMC)功能受累的遗传性血管病:




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    2018-10-22 yinhl1978
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    2018-02-19 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

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    2018-02-17 虈亣靌

    学习了谢谢分享!!

    0

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