关键词: 转甲状腺素蛋白; 心脏淀粉样变; 脑梗死; 脑出血

Abstract: Transthyretin cardiac amyloidosis (ATTR-CA) is a rare and fatal cardiomyopathy caused by the deposition of misfolded transthyretin in the myocardial interstitium. ATTR-CA is often complicated by atrial fibrillation and intracardiac thrombosis, which can lead to cardiogenic cerebral embolism. Additionally, abnormal transthyretin can deposit in the walls of small blood vessels of the leptomeninges, resulting in cerebral amyloid angiopathy, which may subsequently cause intracerebral hemorrhage, subarachnoid hemorrhage, or cerebral infarction. This article reports a case of ATTR-CA presenting as acute multiple cerebral infarctions. During the diagnosis and treatment process, cerebral infarction and bleeding occurred repeatedly. The cause was considered to be transthyretin amyloidosis of the small blood vessels of the leptomeninges. By integrating a literature review, this article aims to elucidate the pathogenesis, clinical characteristics, and treatment outcomes of ATTR-CA complicated by stroke, providing a reference for clinical diagnosis and management.

Key words: Transthyretin; Cardiac amyloidosis; Cerebral infarction; Intracerebral hemorrhage