中英119推理59岁男性，多发脑梗死，

A59-year-oldman,whowasanonsmoker,withpersistenthematuriaandhistoryofmultifocalstrokeswasadmittedforprogressivepainfulrighteyemovementsandbinocularverticaldiplopia.

59岁男性，否认吸烟史，出现持续性血尿，因进展性右侧眼球运动疼痛和垂直性复视被诊断为多发性脑梗死。

Heinitiallypresented2monthspriorwithacuteonsetleft-sidednumbnessandhemiparesis.Hedeniedanyweightlossorconstitutionalsymptoms,butdidreportpersistenthematuriaseveralweekspriortopresentation.Hisgeneralexaminationdidnotrevealanyabnormalskinfindings,organomegaly,lymphadenopathy,orpalpablemasses.HisMRIshowedextensiveembolic-appearinginfarctsinmultiplevascularterritoriesmostconcentratedintherightmiddlecerebralarteryregion(figure,A).

患者在病程的前2个月，出现急性起病的左侧肢体麻木及轻偏瘫。否认体重下降或全身性症状，但在此症状出现前几周存在持续性血尿。一般体格检查未发现异常的皮肤改变、脏器肿大、淋巴结肿大或可触及的包块。MRI检查提示存在多血管分布区的多发栓塞样梗死信号，多集中在右侧大脑中动脉分布区（图A）。

Questionsforconsideration:

1.WhatarethepotentialstrokemechanismsformultifocalinfarctsonMRI?

2.Whatstrokeworkupisre







































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