Türk Beyin Damar Hast Derg. 2021; 27(3): 246-249 | DOI: 10.5505/tbdhd.2021.09326

Brain stem infarction in a young patient associated with probable familial Mediterranean fever: A case report

Erman Altunýþýk, Ýlhan Çað, Ali Arýk
Adýyaman University Training and Research Hospital, Neurology Clinic, Adýyaman, Turkey

Familial Mediterranean fever (FMF) is an auto-inflammatory disease characterized by an autosomal recessive transition, self-limiting, recurrent fever and serositis attacks. Neurological symptoms of FMF are rare. Ischemic stroke, posterior reversible encephalopathy syndrome and demyelinating lesions are shown in FMF patients. A 17-year-old male patient was admitted due to left side weakness for two days. In cranial magnetic resonance diffusion-weighted (MRI-DWI) imaging, an appearance compatible with acute ischemia was detected in mesencephalon right crus cerebri and central localizations. All the young stroke examinations performed for the etiology of the patient who was in remission in terms of FMF were found to be normal. It was thought that the underlying mechanism of young stroke etiology may be the possible subclinical inflammation that causes endothelial dysfunction commonly seen in FMF. A stroke case with this rare complication was found worth presenting.

Keywords: Infarction, familial Mediterranean fever, brain stem, magnetic resonance imaging.

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Muhtemel ailesel Akdeniz ateþi ile iliþkili genç beyin sapý enfarktý olgusu: Vaka sunumu

Erman Altunýþýk, Ýlhan Çað, Ali Arýk
Adýyaman Üniversitesi Eðitim ve Araþtýrma Hastanesi, Nöroloji Kliniði, Adýyaman

Ailesel Akdeniz ateþi (FMF) otozomal resesif geçiþli, kendi kendini sýnýrlayan, tekrarlayan ateþ ve serozit ataklarýyla karakterize otoinflamatuvar bir hastalýktýr. FMF'nin nörolojik belirtileri nadirdir. Ýskemik inme, posterior reversibl ensefalopati sendromu ve demiyelinizan lezyonlar FMF hastalarýnda gösterilmiþtir. 17 yaþ erkek hasta iki günden beri olan sol yan kuvvetsizliði nedeniyle baþvurdu. Kranial manyetik rezonans difüzyon aðýrlýklý (MRG-DAG) görüntülemede mezensefalon sað krus serebri ve santral lokalizasyonlarýnda akut iskemi ile uyumlu görünüm saptandý. FMF açýsýndan remisyonda olan hastanýn etiyolojiye yönelik olarak yapýlan tüm genç inme tetkikleri normal bulundu. Genç inme etiyolojisinin altýnda yatan mekanizmanýn FMF’de yaygýn olarak görülen endotel disfonksiyonuna neden olan muhtemel subklinik inflamasyon olabileceði düþünüldü. Nadir görülen bu komplikasyona sahip inme olgusu sunulmaya deðer bulunmuþtur.

Anahtar Kelimeler: Enfarkt, ailesel Akdeniz ateþi, beyin sapý, manyetik rezonans görüntüleme.

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