Cerebral Infarcts Associated with Adenomyosis Among Middle-aged Women
Cerebral Infarcts Associated with Adenomyosis Among Middle-aged Women
复制标题
DOI：
10.1016/j.jstrokecerebrovasdis.2011.10.017
复制
发表时间：
2012-11-01
影响因子：
2.5
通讯作者：
Urabe, Takao
中科院分区：
文献类型：
--
作者：
Yamashiro, Kazuo;Tanaka, Ryota;Urabe, Takao
脑梗死与恶性肿瘤的高凝状态已被广泛认识。然而，关于良性妇科肿瘤（如子宫腺肌病）患者发生脑梗死的报道非常有限。我们报告4例子宫腺肌病合并脑梗塞的病例，均无明显的常规脑梗塞病因。脑磁共振成像显示所有患者的皮质和皮质下区域以及3例患者的不同动脉区域的多发性脑梗死。两名患者还在手指或肾脏中发生全身性栓塞。1例患者在头臂动脉干和左锁骨下动脉中有血栓。脑梗死急性期凝血标志物水平升高。虽然脑梗死在子宫腺肌病患者中可能并不常见，但这些患者可能存在发生与高凝状态相关的脑梗死的潜在风险，高凝状态与粘液性肿瘤标志物水平升高、凝血相关凝血病或组织因子表达水平升高相关。需要进一步的研究来确定子宫腺肌病脑梗死发生的潜在机制;然而，医生需要特别注意那些患有子宫腺肌病的中年妇女中的高凝状态。
Cerebral infarcts associated with hypercoagulability in malignant tumors have been well recognized. However, reports on cerebral infarcts in patients with a benign gynecologic tumor, such as adenomyosis, are extremely limited. We report the cases of 4 patients with adenomyosis and cerebral infarcts, all without obvious evidence of conventional causes of cerebral infarcts. Brain magnetic resonance imaging revealed multiple cerebral infarcts in both cortical and subcortical areas in all the patients and in different arterial territories in 3 patients. Two patients also had systemic embolism in the fingers or kidneys. One patient had thrombi in the brachiocephalic trunk and left subclavian artery. The levels of coagulation markers were elevated in the acute phase of cerebral infarcts. Although cerebral infarcts might be uncommon in adenomyosis patients, these patients might be potentially at risk of developing cerebral infarcts associated with hypercoagulability related to increased mucinous tumor marker levels, menstruation-related coagulopathy, or increased tissue factor expression levels. Additional study is required to determine the mechanism underlying the development of cerebral infarcts in adenomyosis; however, physicians need to pay particular attention to those who have hypercoagulability with adenomyosis among middle-aged women.