脑淀粉样血管病相关短暂性局灶性神经症状发作的临床、影像及诊治分析(附3例病例报告及文献复习)  

The clinical,imaging features of CAA-TFNE and analysis of diagnosis and treatment(With 3 case reports and literature review)

作　　者：孙金梅[1] 杨佳[1] 李继梅[1] 刘占东[1] 许春伶[1] SUN Jinmei;YANG Jia;LI Jimei(Department of Neurology,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院神经内科

出　　处：《中风与神经疾病杂志》2019年第5期401-405,共5页Journal of Apoplexy and Nervous Diseases

基　　金：国家自然科学基金(No.81801334)

摘　　要：目的探讨脑淀粉样血管病相关短暂性局灶性神经症状发作(CAA-TFNE)的临床特点、影像学特点及治疗方案选择。方法通过回顾性分析3例典型CAA-TFNE病例的临床资料、影像学特点、治疗情况及预后,并结合文献总结该病的临床特点。结果3例患者结合临床表现及影像学诊断为CAA-TFNE,2例患者表现为发作性的肢体麻木和无力,另1例患者表现为发作性的感觉性失语,3例患者血尿便常规、生化、颅内动、静脉血管等未见明确异常,3例患者的影像学提示头部核磁SWI的皮质蛛网膜下腔出血和皮质含铁血黄素沉积,2例患者认知功能存在减退,1例患者认知正常,给予抗癫痫药物后3例患者的发作性症状基本缓解。结论CAA-TFNE是一种临床少见的疾病,临床发作特点为反复、短暂,刻板。正确识别该病对于抗栓策略的选择及后期脑出血的预防具有重要意义。Objective To investigate the clinical presentation,imaging features,diagnosis and therapy of CAA-TFNE.Methods The clinical data of 3 patient who were diagnosed with CAA-TFNE were studied retrospectively,and the related literatures were reviewed.Results The three cases were diagnosed as CAA-TFNE by clinical manifestations and MRI examination.2 cases present with recurrent numbness and weakness,case 3 present with recurrent sensory aphasia,all three patients showed cSS and/or cSAH on MRI-SWI.2 Patient has cognition decline,the other 1 patient showed normal on MMSE and MOCA test.All three of them showed positive repose to antiepileptic drug.Conclusion CAA-TFNE is rare clinically,with transient,repeat,stereotype as clinical feature.It is really important to recognize this disease and avoid of selection of antithrombotic strategies to prevent future cerebral hemorrhage stroke.

关 键 词：脑淀粉样血管病 短暂性局灶性神经症状发作 影像学 抗癫痫治疗 

分 类 号：R743[医药卫生—神经病学与精神病学]