Clinical analysis of paradoxical cerebral embolism from pulmonary embolism
10.3760/cma.j.issn.1671-0282.2012.11.019
- VernacularTitle:肺动脉栓塞致矛盾性脑栓塞的临床分析
- Author:
Hua GE
;
Weihong ZHENG
;
Yongjian WANG
;
Renjing ZHU
- Publication Type:Journal Article
- Keywords:
Pulmonary embolism;
Paradoxical cerebral embolism;
Diagnosis
- From:
Chinese Journal of Emergency Medicine
2012;21(11):1257-1259
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the diagnosis and treatment of cerebral embolism from pulmonary embolism (PE).Methods The clinical data of 5 cases with PE accompanied by cerebral embolism covering a period from October of 2007 to July of 2011 were retrospectively analyzed.Results In this study,the average age of 5 cases (all female) was 46.5 years old.PE was diagnosed through enhanced CT and ECT in lung among all 5 cases.Moderate to severe pulmonary hypertension was confirmed by echocardiogram.Two cases was patent foramen ovale and one was congenital atrial septal defect.Each patient was diagnosed to be new-onset cerebral infarction by MRI.Three cases underwent cerebral arterial thrombolysis.All of them survived and long-term anticoagulant treatment with Warfarin.INR was adjusted between 2.0 and 2.5 by change of Warfarin dose.Among them,one patient had cerebral embolism again just 3 days after the latest cerebral embolism; the other 4 patients did not suffer from cerebral embolism during the follow-up.Conclusions Paradoxical cerebral embolism is common.For clinical patients with PE,especially pulmonary hypertension accompanied by systemic circulation arterial embolism or unexplained systemic cerebral arterial embolism,paradoxical cerebral embolism should be considered.
