27例对称性胼胝体病变病因、临床和神经影像学特点分析  

Etiological, clinical and neuroimaging features of symmetric corpus callosum lesions of 27 ;patients

作　　者：张淑江 吕志宇 荣本兵 李作孝 

机构地区：[1]西南医科大学附属医院神经内科,四川泸州646000

出　　处：《中国医师进修杂志》2016年第9期805-807,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的：探讨对称性胼胝体病变病因、临床和神经影像学特点。方法回顾性分析27例对称性胼胝体病变患者的病因、临床和神经影像学资料。结果27例对称性胼胝体病变患者中16例为慢性酒精中毒性脑病，5例为病毒性脑炎，2例为水电解质代谢紊乱，1例为急性播散性脑脊髓炎，2例脑外伤后，1例原因不明。临床表现：意识障碍8例，精神行为异常5例，癫痫发作5例，共济失调4例，构音障碍3例，头痛2例，头颅CT及MRI均可见胼胝体对称性病变，CT表现为对称性胼胝体低密度灶，边界规则，头颅MRI表现为对称性胼胝体异常信号影，T1WI为低信号， T2WI、Flair、DWI为高信号，伴或不伴颅内其他部分病变。随访头颅MRI病灶消失15例，病灶持续存在7例，4例失访，1例死亡。结论胼胝体对称性病变的病因涉及慢性酒精中毒、感染、水电解质代谢紊乱、脱髓鞘等，甚至有的患者无明显病因可循，临床上主要是对因及对症治疗。Objective To investigate the etiological, clinical and neuroimaging features of symmetric corpus callosum lesions. Methods The clinical data of 27 patients with symmetric corpus callosum lesions were analyzed including the etiological, clinical and neuroimaging data retrospectively. Results In 27 patients, 16 patients suffered from chronic alcoholic encephalopathy, 5 patients suffered from viral encephalitis, 2 patients suffered from disturbance of water and electrolyte, 1 patient suffered from acute disseminated encephalomyelitis（ADEM）, 2 patients suffered from brain trauma, and the etiology of 1 patient was unknown. Clinical manifestation： 8 patients had conscious disturbance, 5 patients had psychological and behavior disorder, 5 patients had epileptic seizure, 4 patients had ataxia, 3 patients had dysarthria and 2 patients had headache. There were abnormalities in CT scans and MRI. Manifestations in CT scans were symmetric low-density focus with clear boundary in corpus callosum. The performance in MRI was low-signals on T1WI but high signals on T2WI and DWI images, and there might be other intracranial lesions. In the follow-up period, foci disappeared in 15 patients, and foci＆nbsp;persisted in 7 patients. Four patients lost in follow-up periods, and 1 patient was not followed up because of death. Conclusions The causes of symmetric corpus callosum lesions include chronic alcoholic encephalopathy, infections, disturbance of water and electrolyte and demyelination. And in some patients the cause is unknown up to now. The etiological treatment and symptomatic treatment are the common treating ways in clinic.

关 键 词：胼胝体 体层摄影术 X线计算机 磁共振成像 

分 类 号：R742[医药卫生—神经病学与精神病学]