Cerebral ischemia with mitral valve prolapse.
Cerebral ischemia with mitral valve prolapse.
复制标题
脑缺血伴二尖瓣脱垂。
DOI：
10.1016/0002-8703(87)90959-8
复制
发表时间：
1987
影响因子：
4.8
通讯作者：
Sila,CA
中科院分区：
文献类型：
--
作者：
Wolf,PA;Sila,CA
1966年，Barlow和Bosman报告了一名23岁的女性患者，她患有短暂的左臂无力，二尖瓣瓣叶脱垂，之前被告知她的心脏异常。在对二尖瓣脱垂（MVP）患者不明原因脑缺血的初步描述中，作者没有强调可能的病理关系;没有介绍该病例的其他神经系统特征。MVP和脑缺血之间的关系最早是在1974年提出的，当时Barnett 2报道了4例MVP和脑缺血事件的患者。1976年，又有8名患者加入到这一初始组中，1977年又增加了2名患者。4所有这些患者都很年轻，年龄在10 ~ 48岁之间，没有动脉粥样硬化的诱发因素;没有冠状动脉疾病和颅内或颅外动脉粥样硬化性动脉疾病。发现的唯一异常是心血管造影发现的MVP。Bamett推测，源于二尖瓣异常的栓子是脑缺血事件的原因。神经功能缺损的局灶性、三名患者在不同时间累及两个半球以及六名患者闭塞的颅内动脉的血管造影照片都有利于栓塞机制。1980年，巴内特等人5发表了一项病例对照系列研究，强烈支持MVP与年轻人视网膜缺血事件之间的因果关系。这些病例包括60名45岁或以下的患者，他们在短暂性脑缺血发作（TIA）或轻微非进展性卒中后入院。所有患者均接受M型超声心动图检查。平等
In 1966 Barlow and Bosman’reported on the case of a 23-year-old woman with transient left arm weakness with a prolapeing mitral valve leaflet who had previously been told that her heart was abnormal. In this initial description of unexplained cerebral ischemia in a patient with mitral valve prolapse (MVP), the authors did not emphasize a possible pathologic relationship; no other neurologic features of the case were presented. The relationship between MVP and cerebral ischemia was first postulated in 1974 when Barnett2 reported four patients with MVP and cerebral ischemic events. To this initial group, another eight patients were added in 19763 and two more in 1977.4 All these patients were young-10 to 48 years of age-and none had predisposing factors for atherosclerosis; coronary artery disease and intracranial or extracranial atherosclerotic arterial disease were absent. The only abnormality found was MVP, discovered on angiocardiogram. Bamett postulated that an embolus originating from the abnormal mitral valve was responsible for the cerebral ischemic event. The focal nature of the neurologic deficit, the involvement of both hemispheres at different times in three of the patients and angiographic pictures of occluded intracranial arteries in six of the patients, all favored an embolic mechanism. In 1980 Barnett et al5 published a case-control series strongly supporting a causal relationship between MVP and cerebroretinal ischemic events in a young person. The cases comprised 60 patients, 45 years old or younger, who were admitted after transient ischemic attacks (TIA) or minor nonprogressing strokes. All patients received a M-mode echocardiographic examination. An equal