[A case of the occlusion of the right middle cerebral artery due to congenital anti-thrombin III (AT III) deficiency (author's transl)].
The authors describe and discuss a case of the occlusion of the right middle cerebral artery due to congenital AT III deficiency. The patient, 23 years old, female, was admitted to our service with episodes of convulsive attacks, disturbance of consciousness and left hemiparesis on the fifth postoperative (laparotomy)day. She had been suffering from recurrent thromnbophlebitis of both legs. Right carotid angiogram revealed the occlusion of the trunk of the right middle cerebral artery about 13mm distal to its bifurcation. Routine laboratory findings on admission, including hematological tests, chemical tests of blood, liver function tests, kidney function tests, chest x-ray film and electrocardiogram, were within normal limits except leukocytosis. But examinations of coagulation and fibrinolysis showed decreased AT III activity and increased AT III antigen concentration. When examined her eight family members on the same examination, six individuals were affected with the decreased AT III activity. On about fourth hospital month, her neurological symptoms took a sudden turn for the worse again. But AT III concentrates transfusion and prescription of warfarin led to her striking clinical improvement. Eight cases of cerebral vessel disease due to congenital AT III deficiency were reported in literature. It is now concluded that AT III deficiency should be considered with one of the etiology of cerebral infarction and cerebral sinus thrombosis in young adults.
D000328:Adult; D020152:Antithrombin III Deficiency; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed