Cerebrovascular ischemia following ultrasound-guided foam sclerotherapy

Abstract Cerebral ischemia is a very rare and harmful complication of ultrasound-guided foam sclerotherapy for treatment of varicose veins. This case describes a documented cerebrovascular ischemia in Broca’s area following ultrasound-guided foam sclerotherapy. Less than one hour after intravenous injection of 10 ml of sclerosing foam, an otherwise healthy woman experienced aphasia without any other signs of neurological changes. When she arrived home, a complete inability to talk was observed. The event was misdiagnosed by another doctor as an allergic reaction. Next morning she came to the office to report the allergic reaction, where an appropriate diagnosis was made. She recovered just two days after the injection, but signs of recent cerebral ischemia were seen in Broca’s area on magnetic resonance and transesophageal bubble study echocardiogram revealed a patent foramen ovale. Although rare, we must make great effort to prevent these events instead of treating them.

摘要 脑缺血是超声引导下泡沫硬化疗法治疗静脉曲张的一种极为罕见且危害性较强的并发症。本病例报告了1例接受超声引导下泡沫硬化疗法后出现布洛卡区（Broca’s area）脑血管缺血的确诊病例：一名既往体健的女性在静脉注射10ml硬化剂泡沫后不到1小时即出现失语症，未伴随其他神经系统体征改变。患者返家后被发现完全无法言语，该事件曾被另一名医生误诊为过敏反应。次日上午，患者前往诊室就诊并提及此次“过敏反应”，接诊医师遂作出正确诊断。患者在注射后仅2天便康复，但磁共振成像检查显示其布洛卡区存在近期脑缺血征象，经食管气泡超声心动图检查发现其存在卵圆孔未闭。尽管此类事件较为罕见，我们仍需全力采取预防措施，而非仅在事件发生后进行治疗。