一病例報告：燒傷後腦梗塞

Cerebral Infarction after Burns: A Case Report

一位43歲男性在1年多前因工作遭香蕉水（banana oil，Isoamyl acetate，常合併其他有機溶劑配置而成的溶劑，為無色透明液體，極易揮發和燃燒）噴濺，導致全身2至3度體表面積30%之燒傷，並合併雙側前臂腔室症候群(compartment syndrome)，經過筋膜切開術、清瘡及植皮手術後，在燒傷後12天併發右側中大腦動脈梗塞。檢視其中風危險因子，病患本身無中風病史及中風家族史，血液檢查除了發現高密度膽固醇極低(HDL: 7mg/dL)外，並無其他明顯導致腦梗塞的危險因子。此個案為燒傷後腦梗塞的案例，本文除了探討燒傷後併發腦梗塞之機轉外，冀望提醒臨床醫師在照顧燒傷病患時需注意是否有腦梗塞併發症之可能。

We presented a 43 year-old male with 30% of the total body surface area in 2nd to 3rd degree burns due to injury by the flame of isoamyl acetate during work. Immediately after admission to our burn center, emergent fasciotomy of bilateral forearms was performed, followed later by wound debridement and split-thickness skin grafts. The patient, however, had cerebral infarction of right middle cerebral artery on the 12th days following admission. Risk factors of cerebral infarction were examined and appeared to be within normal limits except extremely low levels of high-density lipoprotein cholesterol (HDL: 7 mg/dL). Neither past history of stroke nor family history of stroke was reported. This case, an uncommon complication of burn, was reported to discuss the possible mechanism of stroke after burns and to remind physicians to pay attention to this complication in clinical practice.