Multiple cerebral artery occlusion due to non-bacterial thrombotic endocarditis: an autopsy case report
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- Nagakane Yoshinari
- Department of Neurology, Kyoto Second Red Cross Hospital
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- Takezawa Hidesato
- Department of Neurology, Kyoto Second Red Cross Hospital
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- Katsura Kanade
- Department of Histopathology and Cytology, Kyoto Second Red Cross Hospital
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- Yamamoto Yasumasa
- Department of Neurology, Kyoto Second Red Cross Hospital
Bibliographic Information
- Other Title
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- 非細菌性血栓性心内膜炎により多発脳血管閉塞をきたした1剖検例
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Abstract
A 60-year-old man was admitted to our hospital because of vertigo and repeated vomiting, which suddenly occurred 25 hours before admission. Neurologic examination revealed Wallenberg syndrome on the left side, and brain MRI showed acute infarcts in the left lateral medulla as well as in the left internal carotid artery (ICA) territory. MR angiography did not depict the left vertebral artery (VA) and the left ICA. Despite antithrombotic treatment, he developed bulbar palsy, and then, brain herniation due to infarct growth in the left middle cerebral artery territory. He died on day 9. Histopathlogical examination found verruca involving the mitral leaflet, which was consistent with non-bacterial thrombotic endocarditis (NBTE). Atherosclerosis was also found in the systemic arteries, and there was sclerotic stenosis with calcification at the portion of piercing dulla matter in the left VA and at the cavernous segment of the left ICA. Because the cerebral emboli in the narrowed lumen presented a histologic appearance similar to that of the verruca, the diagnosis of brain embolism due to NBTE was confirmed.
Journal
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- Rinsho Shinkeigaku
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Rinsho Shinkeigaku 56 (3), 191-195, 2016
Societas Neurologica Japonica
