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英文誌(2004-)

Journal of Medical Ultrasonics

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1985 - Vol.12

Vol.12 No.03

Case Report(症例報告)

(0234 - 0239)

ファロー四徴乳児に発症した非出血性脳梗塞の脳エコー像

Ultrasonographic Findings of Nonhemorrhagic Cerebral Infarction in an Infant with Tetralogy of Fallot

谷野 定之1, 倉松 俊弘1, 中島 裕司1, 宮尾 益知1, 柳沢 正義1, 鴨下 重彦1, 伊東 紘一2

Sadayuki YANO1, Toshihiro KURAMATSU1, Yuji NAKAJIMA1, Masutomo MIYAO1, Masayoshi YANAGISAWA1, Shigehiko KAMOSHITA1, Kouichi ITOH2

1自治医科大学小児科, 2自治医科大学臨床病理

1Department of Pediatrics, Jichi Medical School, 2Department of Clinical Pathology, Jichi Medical School

キーワード : Tetralogy of Fallot, Secondary polycythemia, Nonhemorrhagic cerebral infarction, Brain ultrasonogram, Hyperechoic lesion

 Cerebral infarction occurs in about 1% of patients with cyanotic congenital heart diseases such as tetralogy of Fallot and transposition of great arteries, the majority of the patients being under 2 years of age. In this study, brain ultrasonograms of 8 month-old infant with tetralogy of Fallot, polycythemia and iron deficiency (RBC 736×104 /mm3, Fe 41 μg/dl) since the onset of illness, which occured as right side hemiplegia, were studied serially. Homogeneously hyperechoic lesion of left caudate nucleus, putamen and internal capsule and narrowed anterior horn of left lateral ventricle were apparent on the day of onset. At 1∼2 weeks later, echogenicity of the lesion became intenser than it had been at the onset and gradually weakened thereafter. On the other hand, the lesion was presented as low density area on CT images since the onset. These CT findings and serial changes in echogenicity since onset would seem to indicate that the lesion was a nonhemorrhagic infarction.