海洛因海绵状白质脑病的临床和影像特点  

Clinical and neuroimaging features of heroin spongiform leukoencephalopathy

作　　者：周亮[1] 陆兵勋[1] 尹恝[1] 

机构地区：[1]南方医科大学南方医院神经内科,广东广州510515

出　　处：《南方医科大学学报》2009年第12期2464-2467,共4页Journal of Southern Medical University

基　　金：广东省自然科学基金(915105150100003)

摘　　要：目的总结海洛因海绵状白质脑病的临床和影像特点。方法对42例确诊患者的临床资料进行回顾性分析。结果海洛因海绵状白质脑病的临床和影像特点如下:(1)有烫吸海洛因史;(2)急性或亚急性起病;(3)小脑受损为首发症状,进一步加重可出现锥体系及锥体外系受损表现,甚至昏迷、去皮层状态,但感觉系统不受累;(4)CT和MRI影像显示病灶位于脑白质区,呈广泛、对称性损害,其中小脑受累严重,小脑中线两旁、边界清楚的对称性类圆形或蝴蝶样病灶最具特点;(5)病理显示脑白质空泡样变。结论结合烫吸海洛因病史、典型临床表现及影像学特点可确诊本病。Objective To summarize the clinical and radiographic characteristics of heroin spongiform leukoencephalopathy （HSLE）. Methods A clinical analysis of 42 cases of HSLE was conducted. Results Clinically, the patients with HSLE all had a positive history of inhalation of heated heroin vapor with acute or subacute onset in most cases, presenting initially cerebellar signs. Pyramidal tract lesion was frequently involved, but the sensory system usually remained normal. The consciousness disturbances may occur in the serious cases. Brain CT and magnetic resonance imaging （MRI） revealed extensive symmetric white matter lesions in the cerebrum and cerebellum, and in serious cases, the midbrain and pons could be damaged. Spongiform vacuoles degeneration of white matter characterized the predominant pathological changes. Conclusion Spongiform leukoencephalopathy should be considered in a patient who shows acute cerebellar signs and reports a history of inhaling heated heroin vapor, and a definite diagnosis of HSLE can be made in such a case upon the identification of typical CT or MRI findings.

关 键 词：海洛因 海绵状白质脑病 神经影像牲 

分 类 号：R747.9[医药卫生—神经病学与精神病学]