A Case of Reversed Robin Hood Syndrome: A Prognostic Indicator for an Urgent Therapy

I. Zivi , M. Hamam , G. Misaggi , P. Stanzione , M. Diomedi
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Abstract

Introduction

In acute stroke, the diagnosis of reversed Robin Hood syndrome (RRHS) by transcranial Doppler (TCD) helps to identify patients at high risk for neurological deterioration.

Report

A patient with left intracranial internal carotid artery (ICA) dissection and concomitant inadequate collateral circulation suffered from recurrent ipsilateral ischaemic symptoms, not prevented by the best medical treatment. TCD showed an RRHS. Stenting of ICA could restore an adequate flow with disappearance of the RRHS and prevention of further episodes.

Discussion

An invasive emergency treatment should be considered in those stroke patients in which TCD detects an inadequate haemodynamic status.

逆转罗宾汉综合征1例:紧急治疗的预后指标
在急性脑卒中中,经颅多普勒(TCD)诊断逆行罗宾汉综合征(RRHS)有助于识别神经功能恶化的高危患者。报告1例左侧颅内颈内动脉夹层伴侧支循环不足的患者反复出现同侧缺血性症状,经最佳药物治疗均无效。TCD显示RRHS。ICA支架植入术可以恢复足够的血流,RRHS消失,预防进一步发作。对于TCD检测到血流动力学状态不佳的脑卒中患者,应考虑有创性急诊治疗。
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