지속성 좌측 상대정맥 환자에서 발생한 드문 색전성 뇌졸중
Unusual paradoxical embolic stroke in a patient with persistent left superior vena cava
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Cardiogenic embolic stroke accounts for approximately 20% of ischemic strokes and the likelihood of its recurrence is high. Paradoxical embolism may be an important cause of cardioembolic stroke, which can be evaluated through multiple diagnostic modalities including transesophageal echocardiography (TTE) or transcranial Doppler. A persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly, which mainly drains to the right atrium via the coronary sinus. Although rare, PLSVC draining into the left heart predisposes the patient to paradoxical embolism through a right-to-left shunt. We report on a 78-year-old female patient with an ischemic stroke associated with PLSVC draining into the left atrium through the pulmonary vein, which was investigated via TTE with an agitated saline test and computed tomography.
Abstract
Cardiogenic embolic stroke accounts for approximately 20% of ischemic strokes and the likelihood of its recurrence is high. Paradoxical embolism may be an important cause of cardioembolic stroke, which can be evaluated through multiple diagnostic modalities including transesophageal echocardiography (TTE) or transcranial Doppler. A persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly, which mainly drains to the right atrium via the coronary sinus. Although rare, PLSVC draining into the left heart predisposes the patient to paradoxical embolism through a right-to-left shunt. We report on a 78-year-old female patient with an ischemic stroke associated with PLSVC draining into the left atrium through the pulmonary vein, which was investigated via TTE with an agitated saline test and computed tomography.
참고문헌 (10)
- Arboix A, "Cardioembolic stroke: clinical features, specific cardiac disorders and prognosis", Curr Cardiol Rev, 6, pp.150~161 (2010)
- Sarodia BD, "Persistent left superior vena cava: case report and literature review", Respir Care, 45, pp.411~416 (2000)
- Saranteas T, "Transesophageal echocardiography and vascular ultrasound in the diagnosis of catheter-related persistent left superior vena cava thrombosis", Eur J Echocardiogr, 10, pp.452~455 (2009)
- Kong PK, "Unroofed coronary sinus and persistent left superior vena cava", Eur J Echocardiogr, 8, pp.398~401 (2007)
- Edwards JE, "Thoracic venous anomalies. I. Vascular connection of the left atrium and the left innominate vein (levoatriocardinal vein) associated with mitral atresia and premature closure of the foramen ovale (case 1). II. Pulmonary veins draining wholly into the ductus venosus (case 2)", Arch Pathol, 49, pp.517~537 (1950)
- Ratliff HL, "Persistent left superior vena cava:case reports and clinical implications", Int J Cardiol, 113, pp.242~246 (2006)
- De Geest B, "Isolated left sided superior vena cava draining into the left atrium associated with recurring intracerebral abscesses. A case report", Acta Cardiol, 49, pp.175~182 (1994)
- Troost E, "Percutaneous closure of a persistent left superior vena cava connected to the left atrium", Int J Cardiol, 106, pp.365~366 (2006)
- Erol I, "Brain abscess associated with isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect", Cardiovasc Intervent Radiol, 29, pp.454~456 (2006)
- Hutyra M, "Persistent left superior vena cava connected through the left upper pulmonary vein to the left atrium: an unusual pathway for paradoxical embolization and a rare cause of recurrent transient ischaemic attack", Eur J Echocardiogr, 11, pp.E35~ (2010)