title: [Two cases of Duchenne muscular dystrophy complicated with dilated cardiomyopathy and cerebral infarction].
abstract: We report two cases of Duchenne muscular dystrophy (DMD) complicated with dilated cardiomyopathy (DCM), who were affected with cerebral infarction. Case 1 suddenly developed dysarthria and right facial weakness at age 21. Cranial CT study disclosed a low density area in the left basal ganglia and internal capsule. Case 2 had a history of transient ischemic attack (TIA) at age 21. Five months after the TIA, he developed right hemiplegia and dysarthria, and a low density area in the corona radiate in left cerebral hemisphere was observed in cranial CT. These two cases showed the radiographic cardiomegaly with cardio thoracic ratio (CTR) of 72.8% and 66.6%, the decreased echocardiographic left ventricular ejection fraction below 20%, and the elevated titer of thrombin-anti-thrombin III complex (TAT) and D-dimer. The autopsy of Case 2 at age 26 disclosed the remarkable degeneration and fibrosis of myocardium and old ischemic lesion in the left cerebral frontal cortex. Despite the negative finding of the emboli in the left heart, cardiogenic cerebral infarction secondary to DCM was strongly suspected in both cases.
authors.affiliation: Department of Internal Medicine, Suzuka National Hospital, Mie, Japan.
authors.forename: Chizuru
authors.initials: C
authors.lastname: Ikeniwa
authors.forename: Motoko
authors.initials: M
authors.lastname: Sakai
authors.forename: Seigo
authors.initials: S
authors.lastname: Kimura
authors.forename: Tadashi
authors.initials: T
authors.lastname: Wakayama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuru
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Yasuma
authors.forename: Masaaki
authors.initials: M
authors.lastname: Konagaya
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000209:etiology*; D002544:Cerebral Infarction / Q000209:etiology*; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000150:complications*