| 张秋灵,刘瑶,蒋敏,等.成人可逆性胼胝体压部病变综合征: 3例报告及文献回顾[J].安徽医药,2019,23(12):2411-2416. |
| 成人可逆性胼胝体压部病变综合征: 3例报告及文献回顾 |
| Clinical characteristics of reversible splenial lesion syndrome in adults:3 case reports and literature review |
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| DOI：10.3969/j.issn.1009?6469.2019.12.020 |
| 中文关键词: 胼胝体/病理学 磁共振成像 头痛 意识障碍 发热 谵妄 成年人 可逆性胼胝体压部病变综合征 |
| 英文关键词: Corpus callosum/pathology Magnetic resonance imaging Headache Consciousness disorders Fever Delirium Adult Reversible splenial lesion syndrome |
| 基金项目: |
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| 中文摘要: |
| 目的分析成人可逆性胼胝体压部病变综合征临床特点，包括病因、临床表现、实验室检查、磁共振影像学特征、治疗及预后。方法南京大学医学院附属南京鼓楼医院急诊病区 2017年 8月至 2018年 12月诊治的可逆性胼胝体压部病变综合征病例 3例详细报告，并以“可逆性”检索中国知网中国医院数字图书馆中文期刊全文数据库、中国科“胼胝体压部病变”为关键词，技期刊万方数据库，以 2009年 1月至 2018年 12月为限，共检索到中文文献 40余篇，剔除资料不全病例及不符合要求病例，对共 47例成人可逆性胼胝体压部病变综合征病人的临床资料进行回顾性分析。结果成人可逆性胼胝体压部病变综合征发病年龄以青年多见，年龄(29.7±11.4)岁，年龄中位数 27岁，男性明显多于女性。病因多种多样，感染、尤以轻微病毒性脑炎最多见，其次为高原病，其余还有低血糖、细菌性脑膜炎、抗癫痫药撤药等多种病因。临床表现多样，病人可有头痛、发热、呕吐、短暂意识障碍、视物模糊或重影、精神异常、抽搐、口齿不清等各种表现。头颅磁共振成像(MRI)胼胝体压部有孤立的弥散加权成像(diffusion weighted imaging，DWI)高信号、表观弥散系数(apparent diffusion coefficient，ADC)序列低信号病灶，经抗病毒、抗菌或激素、对症治疗，或者仅处理原发病，大多数病人在 10 d左右临床症状缓解，平均在 20 d复查头 MRI，各个序列均显示胼胝体压部病灶完全消失。结论成人可逆性胼胝体压部病变综合征病因多种多样，临床表现无特异性，症状轻微，头 MRI可见胼胝体压部可逆性孤立性病灶，在 DWI序列病灶最明显，呈高信号，治疗无特异性，症状在短期缓解，病灶在短时间内消失，预后良好。 |
| 英文摘要: |
| Objective To investigate the etiology and the clinical manifestations which include laboratory examinations，magneticresonance imaging features，treatment and prognosis of reversible splenial lesion syndrome(RESLES) in adults. Methods The three cases of RESLES being diagnosed and treated in Emergency Ward of Nanjing Drum Tower Hospital from August 2017 to De?cember 2018 were reported in detail.Searching in the full?text database of Chinese journals and the Wanfang database of Chinesescientific and technological journals of CNKI China Hospital Digital Library with key words“RESLES”，there are more than 40 Chi? nese literatures were retrieved from January 2009 to December 2018.Excluding cases with incomplete data and cases that do not meet the requirements，the clinical data of 47 cases of RESLES in adults were retrospectively analyzed.Results The onset of RE? SLES appeared mainly in young adults，with an age of(29.7±11.4)years and a median age of 27.Number of males having the syn? drome was significantly larger than that of females.There are various causes of RESLES.Infection especially mild viral encephalitis is the most common one，followed by altitude sickness.Besides，hypoglycemia，bacterial meningitis and antiepileptic drugs are other possible causes.What is more，the clinical manifestations are also various.Patients may have headache，fever，vomiting，temporarydisturbance of consciousness，blurred or double vision，mental disorders，convulsions，unclear speech and other manifestations.Mag? netic Resonance Imaging(MRI)examinations revealed isolated high?signal lesions of DWI in the splenium of the corpus callosum. After antiviral，antibiotic or hormone treatment，symptomatic treatment，or only treatment of the primary disease，most patients had mild clinical symptoms in about 10 days.On average，the patients were reexamined on head MRI 20 days later，and the lesions of splenium were completely disappeared.Conclusion The etiology of RESLES in adults is varied.Its clinical manifestations have mild symptoms and do not have specificity.The most obvious lesions in DWI is the reversible lesions shown by cranial magnetic res? onance imaging.The reversible lesions appear to be high signal intensity on DWI.The treatment has no specificity，while the symp?toms are mild and the lesions disappear in a short period of time.In the end，the prognosis is good. |
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