可逆性后部白质脑病综合征临床及影像学特点15例分析  

Clinical and neuroimage characteristics of reversible posterior leukoencephalopathy syndrome in fifteen patients

作　　者：程卫国[1] 张剑平[1] 于路[1] 王卓奕[1] 

机构地区：[1]南京医科大学附属无锡人民医院神经内科,江苏214018

出　　处：《脑与神经疾病杂志》2013年第5期366-368,共3页Journal of Brain and Nervous Diseases

摘　　要：目的探讨可逆性后部白质脑病综合征的临床和影像学特征。方法分析15例可逆性后部白质脑病综合征患者的临床和影像学资料。结果 15例可逆性后部白质脑病综合征患者继发于高血压脑病、系统性红斑狼疮、尿毒症、子痫、甲状旁腺腺瘤伴发高钙血症、非霍奇金淋巴瘤、肾移植术后、急性淋巴细胞白血病和神经白塞病。其中血压升高者10例,临床主要表现为头痛、癫痫发作、视物模糊和意识障碍。头颅CT或MRI检查主要表现为对称的枕叶白质脑水肿,部分伴有顶额颞叶等病变。经治疗后患者症状消失,头颅CT或MRI复查病灶完全或大部分消失。结论可逆性后部白质脑病综合征可由多种病因产生,影像学主要表现为大脑后部白质血管源性脑水肿改变,及时治疗后症状和影像学特征迅速改善。Objective To investigate the clinical and imaging characteristics of reversible posterior leukoencephalopathy syndrome（RPLS）.Methods The clinical and imaging data of 15 patients with RPLS were analyzed retrospectively.Results Among the 15 patients with hypertensive encephalopathy,systemic lupus erythematosus,uremia,eclampsia,parathyroid adenoma with hypercalcemia,non-hodgkin ＇s lymphoma,renal transplantation,acute lymphocytic leukemia or neuro-behcet＇s disease.Their main clinical manifestations were headaches,seizures,vision and consciousness disturbance,MRI and CT examination showed symmetrical cerebral edema of bilateral white mattter in occipital lobe,and some in the frontal,parietal,temporal lobe.The symptoms disappeared after active treatment.Imaging examination showed that the lesions disappeared almost completely.Conclusion The causes of RPLS are different.The imaging mainly show the signal of vasogenic brain edema on the posterior white matter of the brain.After timely treatment,the symptoms and imaging features improved rapidly.

关 键 词：可逆性后部白质脑病综合征 脑水肿 磁共振成像 

分 类 号：R741[医药卫生—神经病学与精神病学]