脳梗塞１６

【臨床症状】胆管がん術後

【問題】どこに脳梗塞がある？　また、支配血管、発症時期、病型（分類）について記載せよ

MR_20240607130312_Image020
MR_20240607130312_Image019
MR_20240607130312_Image018
MR_20240607130312_Image017
MR_20240607130312_Image016
MR_20240607130312_Image015
MR_20240607130312_Image014
MR_20240607130312_Image013
MR_20240607130312_Image012
MR_20240607130312_Image011
MR_20240607130312_Image010
MR_20240607130312_Image009
MR_20240607130312_Image008
MR_20240607130312_Image007
MR_20240607130312_Image006
MR_20240607130312_Image005
MR_20240607130312_Image004
MR_20240607130312_Image003
MR_20240607130312_Image002
MR_20240607130312_Image001
MR_20240607130312_Image040
MR_20240607130312_Image039
MR_20240607130312_Image038
MR_20240607130312_Image037
MR_20240607130312_Image036
MR_20240607130312_Image035
MR_20240607130312_Image034
MR_20240607130312_Image033
MR_20240607130312_Image032
MR_20240607130312_Image031
MR_20240607130312_Image030
MR_20240607130312_Image029
MR_20240607130312_Image028
MR_20240607130312_Image027
MR_20240607130312_Image026
MR_20240607130312_Image025
MR_20240607130312_Image024
MR_20240607130312_Image023
MR_20240607130312_Image022
MR_20240607130312_Image021
MR_20240607130312_Image060
MR_20240607130312_Image059
MR_20240607130312_Image058
MR_20240607130312_Image057
MR_20240607130312_Image056
MR_20240607130312_Image055
MR_20240607130312_Image054
MR_20240607130312_Image053
MR_20240607130312_Image052
MR_20240607130312_Image051
MR_20240607130312_Image050
MR_20240607130312_Image049
MR_20240607130312_Image048
MR_20240607130312_Image047
MR_20240607130312_Image046
MR_20240607130312_Image045
MR_20240607130312_Image044
MR_20240607130312_Image043
MR_20240607130312_Image042
MR_20240607130312_Image041
MR_20240607130312_Image061
MR_20240607130312_Image062
MR_20240607130312_Image063
MR_20240607130312_Image064
MR_20240607130312_Image065
MR_20240607130312_Image066
MR_20240607130312_Image067
MR_20240607130312_Image068
MR_20240607130312_Image069
MR_20240607130312_Image070
MR_20240607130312_Image071
MR_20240607130312_Image072
MR_20240607130312_Image073
MR_20240607130312_Image074
MR_20240607130312_Image075
MR_20240607130312_Image090
MR_20240607130312_Image089
MR_20240607130312_Image088
MR_20240607130312_Image087
MR_20240607130312_Image086
MR_20240607130312_Image085
MR_20240607130312_Image084
MR_20240607130312_Image083
MR_20240607130312_Image082
MR_20240607130312_Image081
MR_20240607130312_Image080
MR_20240607130312_Image079
MR_20240607130312_Image078
MR_20240607130312_Image077
MR_20240607130312_Image076
 

    ▶答えはこちら
    • 左右の側頭葉（頭頂葉）を中心にラクナ梗塞巣が点在している
    • いずれもMCA領域だが、MRAでは特に狭窄などの病変は認めない
    • DWIで高信号、ADCで低信号、FLAIRで一部高信号のため急性期（発症1～7日）の梗塞が疑われる
    • 支配血管に依存しない多発ラクナ梗塞であり、胆管がん術後である事から、トルソー症候群を鑑別にあげる必要がある