未确诊法洛四联症的脑脓肿

Kelvin Nemayire, K. Kabulo, Luxwell Jokonya, P. Ntenga, A. Musara, K. Kalangu
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引用次数: 1

摘要

心血管疾病是全世界所有年龄段死亡的主要原因。法洛四联症(TOF)是最常见的紫绀型先天性心脏病(CHD),占10%。有一些与TOF相关的神经系统并发症的报道。虽然已知,脑脓肿(BA)是未矫正冠心病患者的严重并发症,主要发生在4-7岁。我们报告一例7岁的男性谁提出了3个月的历史,左侧身体无力和3周的历史,头痛和发烧。患者自出生以来一直身体不适,他会经历偶尔发作的用力呼吸困难,从未调查过。胸部x线片显示心脏呈球状。脑部CT扫描显示右侧顶叶区1,8 x 1,3 x 1,5 cm环形增强病灶,伴极小的病灶周围血管源性水肿,与侧脑室体连通,脑室室管膜衬层增强;超声心动图显示室间隔缺损,主动脉覆盖,右心室流出道梗阻,右心室肥厚,符合TOF的诊断。我们选择对患者进行静脉注射抗生素的保守治疗,患者神经功能明显改善,并转至心胸外科进一步治疗TOF。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Brain Abscess in Undiagnosed Tetralogy of Fallot
Cardiovascular disease is a leading cause of mortality in all ages worldwide. Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease (CHD) accounting for 10%. There have been several reports of neurological complications associated with TOF. Although it is known, brain abscess (BA) is a serious complication in patients with uncorrected CHD mostly in the age of 4-7 years-old. We report a case of a 7 year old male who presented with a 3 month history of left sided body weakness and a 3 week history of a headache and fever. Patient was chronically unwell since birth where he would experience occasional episodes of exertional dyspnoea which was never investigated. Chest xray showed a globular-shaped heart. CT scan brain showed a 1,8 x 1,3 x 1,5 cm ring-enhancing lesion in the right parietal region with minimal perilesional vasogenic edema communicating with the body of the lateral ventricle, with enhancement of the ependymal lining of the ventricle; echocardiography revealed ventricular septal defect (VSD), overriding of aorta, obstruction to right ventricular outflow tract and hypertrophy of right ventricle consistent with a diagnosis of TOF. We elected to manage the patient conservatively on intravenous antibiotics, Patient improved significantly neurologically and was transferred to the cardiothoracic surgeons for further management of TOF.
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