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目的探讨可逆性后部白质脑病综合征常见病因、临床表现、影像学特征及治疗,以提高确诊率及治疗效果。方法回顾性分析21例可逆性后部白质脑病综合征患者的病因、临床表现、影像学特征、治疗及预后。结果 21例患者中6例男性,15例女性。4例子痫,严重高血压7例,系统性红斑狼疮、狼疮性肾病5例,严重肺部感染3例,肿瘤化疗后2例。主要临床表现为急性起病,头痛、呕吐、癫痫、一过性皮质盲。头颅CT及MRI提示枕叶为主、大部分顶叶、颞叶、少部分额叶白质区、脑干、小脑异常信号。经对症、脱水治疗及基础疾病治疗后,神经症状均短时间恢复。结论可逆性后部白质脑病是一组具有一定影像学特征的临床综合征,提高对该组疾病的认识,结合临床表现、基础疾病,能早期明确诊断及治疗,预后良好。
Objective To explore the common etiology, clinical manifestations, imaging features and treatment of reversible posterior leukoencephalopathy syndrome in order to improve the diagnosis rate and treatment effect. Methods The etiology, clinical manifestations, imaging features, treatment and prognosis of 21 patients with reversible posterior leukoencephalopathy syndrome were retrospectively analyzed. Results Of the 21 patients, 6 were male and 15 were female. 4 cases of eclampsia, severe hypertension in 7 cases, systemic lupus erythematosus, 5 cases of lupus nephropathy, severe pulmonary infection in 3 cases, 2 cases after chemotherapy. The main clinical manifestations of acute onset, headache, vomiting, epilepsy, transient cortical blindness. Head CT and MRI tip occipital, most of the parietal lobe, temporal lobe, a small part of the frontal white matter, brain stem, cerebellar abnormalities signal. After symptomatic, dehydration and treatment of underlying diseases, neurological symptoms were recovered in a short time. Conclusion Reversible posterior leukoencephalopathy is a group of clinical syndromes with certain imaging features, which can improve the understanding of this group of diseases. Combined with clinical manifestations, underlying diseases, early diagnosis and treatment can be made with good prognosis.