脳梗塞１１

【臨床症状】もの忘れ

【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

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    ▶答えはこちら
    • 左側頭葉（頭頂葉）を中心に新鮮な梗塞巣あり
    • 支配血管はMCA（中大脳動脈領域）を中心に、一部PCA（後大脳動脈）にもあるか（MCAとPCAの境界領域か）
    • MRA上はPCAの狭窄は明らかではないが、左MCAのM1部で狭窄が疑われる
    • DWIで皮質がスペアされていない事、散在的に梗塞巣がある事から、アテローム性（塞栓性）が疑われる
    • またいずれの所見もDWIで高信号、ADCで低信号、FLAIRで高信号な事から急性期（発症1～7日）と考えられる
    • 他、陳旧性のラクナ梗塞が大脳、脳幹に点在
    • A-comに8mm程度の動脈瘤あり