緩徐進行の麻ひを呈する脳梗塞  [in Japanese] Cerebral infarction with slowly progressing paresis.  [in Japanese]

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Abstract

一側上肢の麻痺やしびれが長期にわたって緩徐に進行した脳梗塞の2例を報告した.症例1は2カ月半にわたって左上肢の感覚障害と麻痺が進行し, 顔面や下肢の麻痺も出現, 右中心前回と中心後回の皮質梗塞, 右Rolandic arteryの造影遅延を認めた.症例2は右手の麻痺が3週間にわたって進行し, 左中心前回と前後の分水嶺の梗塞, 左中大脳動脈M2閉塞を認め, Rolandic arteryへの副血行は不良であった.2例とも初期に適切な診断がなされず治療が遅れたこと, 中大脳動脈分枝病変の存在, 副血行が不良なことが進行型脳梗塞の要因と考えられた.脳腫瘍のような進行を示す中大脳動脈分枝領域の脳梗塞で極めて稀な症例と考えられた.

Two cases of cerebral infarction with slowly progressive paresis are reported. Case 1 was a 54-year-old woman with slow progression of sensory disturbance and paresis in the left upper extremity over 2.5 months. Brain CT and MRI demonstrated cortical infarction in the right precentral and postcentral gyrus, and cerebral angiography disclosed delayed filling of the right Rolandic artery. Case 2 was a 62-year-old man with slow progression of paresis in the right hand over 3 weeks. Brain CT and MRI demonstrated infarctions in the left precentral gyrus, anterior and posterior watersheds on the left side. Cerebral angiography disclosed occlusion of the M2 portion in the left middle cerebral artery, and good collateral circulation except for the rolandic artery. The causes of the progressing ischemic stroke in the two cases were as follows : 1) delay of diagnosis and therapy, 2) lesions of the branch of the middle cerebral artery, and 3) poor collateral circulation to the Rolandic artery.<BR>These represent very rare cases of progressing ischemic stroke in the distribution of the branch of the middle cerebral artery resembling brain tumor.

Journal

  • Nosotchu

    Nosotchu 18(2), 143-148, 1996

    The Japan Stroke Society

Codes

  • NII Article ID (NAID)
    130003438977
  • Text Lang
    JPN
  • ISSN
    0912-0726
  • Data Source
    J-STAGE 
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