PDF(Pubmed)
Abstract：
Stroke is a common acute neurological injury that may develop due to arterial thrombosis or hemorrhage. However, it is uncommon in the young population. The etiologies of stroke in young patients are different compared with those for the elderly population. They include various non-atherosclerotic angiopathies, hematological conditions, and inflammatory disorders. We report the case of a 26-year-old man who presented to the emergency department because he noticed that his right hand had become clumsy. He first noticed this symptom five days before his presentation, but he noticed that his symptom had improved significantly since it began. He reported that he had episodes of neck pain and pain around the ear. He visited the family physician clinic several times for this complaint and was diagnosed as having a temporomandibular joint disorder. Neurological examination revealed decreased muscle strength in the right upper limb with a power of 4/5 along with a sensory deficit. The coordination was intact. No gait ataxia was noted. Considering the patient\'s age, the initial diagnosis was a demyelinating disorder such as multiple sclerosis. The patient underwent magnetic resonance imaging of the brain. It demonstrated an increased signal intensity in the territory of the left middle cerebral artery representing a left-sided infarction. Subsequently, the patient underwent computed tomography angiography of the head to rule out any structural malformation. The scan showed the presence of an elongated styloid process that appeared in close proximity to the neck vasculature. These radiological findings are consistent with Eagle syndrome. The patient underwent surgical resection of the styloid process. Eagle syndrome is a rare clinical condition that may have a myriad of clinical presentations. A high index of suspicion for this condition is vital to reach the diagnosis. Physicians should keep this condition in the differential diagnosis of stroke in the young population with no risk factors.
摘要：
中风是一种常见的急性神经损伤，可能是由于动脉血栓形成或出血引起的。然而,这在年轻人群中并不常见。与老年人群相比，青年患者中风的病因不同。它们包括各种非动脉粥样硬化性血管病变，血液学状况，和炎症性疾病。我们报告了一名26岁的男子的病例，他向急诊科就诊，因为他注意到他的右手变得笨拙。他在演讲前五天第一次注意到这种症状，但他注意到他的症状自开始以来有了显著改善。他报告说他有颈部疼痛和耳朵周围疼痛的发作。为此，他多次前往家庭医生诊所就诊，并被诊断为患有颞下颌关节疾病。神经系统检查显示右上肢的肌肉力量下降，功率为4/5，并伴有感觉缺陷。协调是完整的。没有步态共济失调。考虑到病人的年龄,最初诊断为脱髓鞘疾病，如多发性硬化症。患者接受了脑部磁共振成像。它表明左大脑中动脉区域的信号强度增加，代表左侧梗塞。随后，患者接受了头部计算机断层扫描血管造影，以排除任何结构畸形。扫描显示出现在颈部脉管系统附近的细长茎突。这些放射学发现与Eagle综合征一致。患者接受了茎突手术切除。鹰综合征是一种罕见的临床表现，可能有无数的临床表现。对这种情况的高度怀疑指数对于诊断至关重要。在没有危险因素的年轻人群中，医生应在中风的鉴别诊断中保持这种情况。
