中国卒中杂志 ›› 2025, Vol. 20 ›› Issue (9): 1193-1197.DOI: 10.3969/j.issn.1673-5765.2025.09.015

• 病例讨论 • 上一篇    下一篇

当急性缺血性卒中遇上“栓子雨”

濮月华1,董培1,荆京2,董可辉1,李子孝1,2,龚浠平1   

  1. 1 北京 100070 首都医科大学附属北京天坛医院神经病学中心
    2 国家神经系统疾病临床医学研究中心
  • 收稿日期:2023-07-17 修回日期:2025-08-28 接受日期:2025-09-01 出版日期:2025-09-20 发布日期:2025-09-20
  • 通讯作者: 龚浠平 xipinggong@163.com
  • 基金资助:
    国家自然科学基金面上项目(81870913)

When Acute Ischemic Stroke Encounters an “Embolic Shower”

PU Yuehua1, DONG Pei1, JING Jing2, DONG Kehui1, LI Zixiao1,2, GONG Xiping1   

  1. 1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
    2 China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
  • Received:2023-07-17 Revised:2025-08-28 Accepted:2025-09-01 Online:2025-09-20 Published:2025-09-20
  • Contact: GONG Xiping, E-mail: xipinggong@163.com

摘要: 本文报道1例急性非致残性缺血性卒中患者的临床特点,该患者在进行TCD微栓子监测时发现“栓子雨”现象,7 T HR-MRI检查提示左侧大脑中动脉M1段存在不稳定斑块。患者经双联抗血小板、强化降脂、补液扩容治疗后病情稳定。本病例的诊疗经过提示,对于高危非致残性急性缺血性卒中患者,应尽早明确病因及发病机制,早期给予个体化治疗,以有效预防卒中复发。

关键词: 高危非致残性缺血性卒中; 颅内动脉粥样硬化; 微栓子信号

Abstract: This article reports a case of non-disabling acute ischemic stroke in which TCD microembolic monitoring revealed an “Embolic Shower”, and 7 T HR-MRI revealed unstable plaques in the M1 segment of the left middle cerebral artery. After dual antiplatelet therapy, intensive lipid-lowering, and intravenous fluid therapy, the patient’s condition stabilized. The diagnosis and treatment process of this case suggests that for patients with high-risk non-disabling acute ischemic stroke, the etiology and pathogenesis should be identified as soon as possible, and early individualized treatment is crucial for effectively preventing stroke recurrence.

Key words: High-risk non-disabling acute ischemic stroke; Intracranial atherosclerosis; Microembolic signal

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