PDF(Pubmed)
Abstract：
UNASSIGNED: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an autosomal dominant inherited arterial disease, with lacunar infarction resulting from intracranial small vessel lesions being the most prevalent clinical manifestation of CADASIL. However, large-scale cerebral infarction caused by intracranial non-small vessels occlusion is relatively uncommon, and reports of vascular intervention and long-term antiplatelet drug treatment for patients with CADASIL and large-scale cerebral infarction are rarer.
UNASSIGNED: We reported a 52 year-old male who experienced a significant cerebral infarction due to an occlusion in the second segment of the left middle cerebral artery, 4 months subsequent to being diagnosed with CADASIL. Following the benefit and risk assessment, the patient underwent intracranial vascular thrombectomy and balloon dilation angioplasty. Subsequently, he was administered dual antiplatelet therapy for 3 months, followed by mono antiplatelet therapy.
UNASSIGNED: After undergoing intracranial vascular intervention and receiving antiplatelet therapy, significant improvement in the symptoms were observed. The National Institutes of Health Stroke Scale score decreased from 6 to 2 points, and no bleeding lesions were detected on the head computed tomography during regular follow-up visits after discharge.
UNASSIGNED: Our case highlights the possibility that patients with CADASIL may also encounter extensive cerebral infarction resulting from stenosis or occlusion of intracranial non-small vessels. Considering the specific circumstances of the patient, intravascular intervention and antiplatelet therapy can be regarded as viable treatment options for individuals with CADASIL.
UNASSIGNED: We reported a 52 year-old male who experienced a significant cerebral infarction due to an occlusion in the second segment of the left middle cerebral artery, 4 months subsequent to being diagnosed with CADASIL. Following the benefit and risk assessment, the patient underwent intracranial vascular thrombectomy and balloon dilation angioplasty. Subsequently, he was administered dual antiplatelet therapy for 3 months, followed by mono antiplatelet therapy.
UNASSIGNED: After undergoing intracranial vascular intervention and receiving antiplatelet therapy, significant improvement in the symptoms were observed. The National Institutes of Health Stroke Scale score decreased from 6 to 2 points, and no bleeding lesions were detected on the head computed tomography during regular follow-up visits after discharge.
UNASSIGNED: Our case highlights the possibility that patients with CADASIL may also encounter extensive cerebral infarction resulting from stenosis or occlusion of intracranial non-small vessels. Considering the specific circumstances of the patient, intravascular intervention and antiplatelet therapy can be regarded as viable treatment options for individuals with CADASIL.
摘要：
■伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病(CADASIL)是一种常染色体显性遗传性动脉疾病,颅内小血管病变导致的腔隙性梗死是CADASIL最常见的临床表现。然而,颅内非小血管闭塞引起的大面积脑梗死比较少见,CADASIL和大面积脑梗死患者血管介入治疗和长期抗血小板药物治疗的报道较少。
■我们报道了一名52岁的男性，由于左大脑中动脉第二段闭塞而出现了明显的脑梗塞，4个月后被诊断为CADASIL。在收益和风险评估之后，患者接受了颅内血管血栓切除术和球囊扩张血管成形术。随后，他接受了3个月的双重抗血小板治疗，其次是单抗血小板治疗。
■接受颅内血管介入治疗和抗血小板治疗后，观察到症状显着改善。美国国立卫生研究院卒中量表评分从6分降至2分,出院后定期随访期间，头部计算机断层扫描未发现出血病变。
■我们的案例强调了CADASIL患者也可能因颅内非小血管狭窄或闭塞而遇到广泛的脑梗死的可能性。考虑到患者的具体情况，血管内介入和抗血小板治疗可被视为CADASIL患者的可行治疗选择.
■我们报道了一名52岁的男性，由于左大脑中动脉第二段闭塞而出现了明显的脑梗塞，4个月后被诊断为CADASIL。在收益和风险评估之后，患者接受了颅内血管血栓切除术和球囊扩张血管成形术。随后，他接受了3个月的双重抗血小板治疗，其次是单抗血小板治疗。
■接受颅内血管介入治疗和抗血小板治疗后，观察到症状显着改善。美国国立卫生研究院卒中量表评分从6分降至2分,出院后定期随访期间，头部计算机断层扫描未发现出血病变。
■我们的案例强调了CADASIL患者也可能因颅内非小血管狭窄或闭塞而遇到广泛的脑梗死的可能性。考虑到患者的具体情况，血管内介入和抗血小板治疗可被视为CADASIL患者的可行治疗选择.
