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JAMA Neurol：主动脉瓣膜碎片引起的脑栓塞

2018-09-07 杨中华 脑血管病及重症文献导读

主动脉瓣膜碎片脑栓塞偏瘫
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非洲裔美国女性，80岁。因严重因主动脉狭窄采用人造生物瓣进行了择期经导管主动脉瓣置换术，术中突发右侧偏瘫，NIHSS 31分。

非洲裔美国女性，80岁。

因严重因主动脉狭窄采用人造生物瓣进行了择期经导管主动脉瓣置换术，术中突发右侧偏瘫，NIHSS 31分。

CTA显示左侧MCA远端闭塞，立即机械取栓术，取栓后再通：



术中取去了一个0.5cm的主动脉瓣碎片（下图）：



24h后NIHSS 5分，1周后NIHSS 0分。

原始出处：Alqahtani SA, Ben-Dor II, Liu AH. Cerebral Embolus From Aortic Valve Fragment. JAMA Neurol. 2018 Aug 1;75(8):1022-1023.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1332554, encodeId=dc28133255456, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Sun Sep 09 07:23:00 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415369, encodeId=15051415369ee, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sun Sep 09 07:23:00 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1527501, encodeId=cdb8152e50190, content=<a href='/topic/show?id=3cc9848e889' target=_blank style='color:#2F92EE;'>#脑栓塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84878, encryptionId=3cc9848e889, topicName=脑栓塞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=604911868256, createdName=axin013, createdTime=Sun Sep 09 07:23:00 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583581, encodeId=99ff158358157, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Sun Sep 09 07:23:00 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000572, encodeId=14b120005e2ef, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Tue Jun 18 02:23:00 CST 2019, time=2019-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=343441, encodeId=5fcd343441c6, content=很有用的消息, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLlicehVzPC3BIG5MMT4o0D9CNdMrAdiaz1LvNJDqSoPjibHaiavyvkImlpzzneRgAwFEeCicwRjXhcHbw/132, createdBy=3f1689006, createdName=SSRIs, createdTime=Fri Sep 07 16:32:17 CST 2018, time=2018-09-07, status=1, ipAttribution=)]
    2018-09-09 hittouch

    #主动脉瓣#

    0

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    2018-09-09 circumcision

    #主动脉#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1332554, encodeId=dc28133255456, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Sun Sep 09 07:23:00 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415369, encodeId=15051415369ee, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sun Sep 09 07:23:00 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1527501, encodeId=cdb8152e50190, content=<a href='/topic/show?id=3cc9848e889' target=_blank style='color:#2F92EE;'>#脑栓塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84878, encryptionId=3cc9848e889, topicName=脑栓塞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=604911868256, createdName=axin013, createdTime=Sun Sep 09 07:23:00 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583581, encodeId=99ff158358157, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Sun Sep 09 07:23:00 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000572, encodeId=14b120005e2ef, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Tue Jun 18 02:23:00 CST 2019, time=2019-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=343441, encodeId=5fcd343441c6, content=很有用的消息, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLlicehVzPC3BIG5MMT4o0D9CNdMrAdiaz1LvNJDqSoPjibHaiavyvkImlpzzneRgAwFEeCicwRjXhcHbw/132, createdBy=3f1689006, createdName=SSRIs, createdTime=Fri Sep 07 16:32:17 CST 2018, time=2018-09-07, status=1, ipAttribution=)]
    2018-09-09 axin013

    #脑栓塞#

    0

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    2018-09-09 12498e5fm17(暂无昵称)

    #瓣膜#

    0

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    2019-06-18 yinhl1978

    #Neurol#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1332554, encodeId=dc28133255456, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Sun Sep 09 07:23:00 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415369, encodeId=15051415369ee, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sun Sep 09 07:23:00 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1527501, encodeId=cdb8152e50190, content=<a href='/topic/show?id=3cc9848e889' target=_blank style='color:#2F92EE;'>#脑栓塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84878, encryptionId=3cc9848e889, topicName=脑栓塞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=604911868256, createdName=axin013, createdTime=Sun Sep 09 07:23:00 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583581, encodeId=99ff158358157, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Sun Sep 09 07:23:00 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000572, encodeId=14b120005e2ef, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Tue Jun 18 02:23:00 CST 2019, time=2019-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=343441, encodeId=5fcd343441c6, content=很有用的消息, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLlicehVzPC3BIG5MMT4o0D9CNdMrAdiaz1LvNJDqSoPjibHaiavyvkImlpzzneRgAwFEeCicwRjXhcHbw/132, createdBy=3f1689006, createdName=SSRIs, createdTime=Fri Sep 07 16:32:17 CST 2018, time=2018-09-07, status=1, ipAttribution=)]
    2018-09-07 SSRIs

    很有用的消息

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