Sol Hemipleji Ve Dizartri İle Başvuran Multipl Skleroz Tanılı Hastada Akut İskemik İnme
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Tarih
2018
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info:eu-repo/semantics/openAccess
Özet
Multipl Sklerozda, santral sinir sistemindeki kronik inflamasyonun indüklediği endotelial disfonksiyon ve buna bağlı ateroskleroz serebrovasküler hastalık riskini artırır. Multipl Skleroz (sekonder progressif) ve hipertansiyon (regüle) tanıları olup EDSS skoru 6 olan 54 yaşındaki bayan hasta intravenöz yüksek doz pulse steroid tedavisi sonrası sol tarafında ani güç kaybı, konuşma ve yutma bozukluğu ile getirildi. Acil servisteki difüzyon MR’da mezensefalon ile pons sağ kesiminde, serebellar hemisferlerde difüzyon kısıtlaması gösteren akut enfarkt alanları izlendi. İnme etiyolojisine yönelik yapılan karotisvertebral doopler ultrasonografi ve transtorasik ekokardiografi normaldi. Ritm holterde, aritmi izlenmedi. Rutin laboratuar tetkikleri, tromboz ve vaskülit markerlerinde patoloji saptanmadı. Olguda inme nedeni olarak Multipl Skleroz ve immobilite düşünüldü. Multipl Skleroz hastalarında yeni gelişen nörolojik disfonksiyon durumunda atak dışı neden, inme olasılığı da her zaman akılda tutulmalıdır.
Endothelial dysfunction induced by chronic inflammation in the central nervous system and associated atherosclerosis increases the risk of cerebrovascular disease in Multiple Sclerosis. A 54 years-old woman with multiple sclerosis (secondary progressive), hypertension (regular) and EDSS score 6 was brought with sudden loss of power on her left side as well as speech and swallowing disturbances after high dose intravenous pulse steroid therapy. Acute infarcts with diffusion restriction were observed in mesencephalon, cerebellar hemispheres and right side of pons in diffusion MR which was requested in the emergency department. Carotid-vertebral Doppler ultrasonography and transthoracic echocardiography performed to investigate etiology of stroke were normal. Arrhythmia was not observed in rhythm Holter evaluation. Routine laboratory tests, thrombosis and vasculitis markers were found to be normal. Multiple Sclerosis and immobility were considered as the cause of stroke for this patient. The possibility of stroke and a non-attack pathology should always be kept in mind when Multiple Sclerosis patients admit with a new onset neurological dysfunction.
Endothelial dysfunction induced by chronic inflammation in the central nervous system and associated atherosclerosis increases the risk of cerebrovascular disease in Multiple Sclerosis. A 54 years-old woman with multiple sclerosis (secondary progressive), hypertension (regular) and EDSS score 6 was brought with sudden loss of power on her left side as well as speech and swallowing disturbances after high dose intravenous pulse steroid therapy. Acute infarcts with diffusion restriction were observed in mesencephalon, cerebellar hemispheres and right side of pons in diffusion MR which was requested in the emergency department. Carotid-vertebral Doppler ultrasonography and transthoracic echocardiography performed to investigate etiology of stroke were normal. Arrhythmia was not observed in rhythm Holter evaluation. Routine laboratory tests, thrombosis and vasculitis markers were found to be normal. Multiple Sclerosis and immobility were considered as the cause of stroke for this patient. The possibility of stroke and a non-attack pathology should always be kept in mind when Multiple Sclerosis patients admit with a new onset neurological dysfunction.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp
Kaynak
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
20
Sayı
1
Künye
Say, B., Tunç, M., Yardımcı, İ., Alpua, M., Ergün, U. (2018). Sol Hemipleji Ve Dizartri İle Başvuran Multipl Skleroz Tanılı Hastada Akut İskemik İnme. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 20(1), 97 - 100.
