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重度子痫前期的皮质盲:计算机断层扫描、磁共振成像及单光子发射计算机断层扫描结果

Cortical blindness in severe preeclampsia: computed tomography, magnetic resonance imaging, and single-photon-emission computed tomography findings.

作者信息

Apollon K M, Robinson J N, Schwartz R B, Norwitz E R

机构信息

Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Obstet Gynecol. 2000 Jun;95(6 Pt 2):1017-9. doi: 10.1016/s0029-7844(00)00878-4.

Abstract

BACKGROUND

Cortical blindness is a complication of severe preeclampsia, but it is unclear whether it results from cerebral vasospasm and ischemic injury or vasogenic (hydrostatic) edema due to increased capillary permeability.

CASE

Reversible cortical blindness in a 33-year-old gravida 2, para 1, with severe postpartum preeclampsia after evacuation of a partial molar pregnancy at 19 weeks' gestation is presented. Initial neuroimaging studies showed hyperperfusion on head single-photon-emission computed tomography scan, which corresponded with lesions found on head computed tomography and magnetic resonance imaging scans. Follow-up neuroimaging studies 2 weeks later, by which time the patient's visual acuity had returned to normal, showed complete resolution of radiologic abnormalities.

CONCLUSION

Neuroimaging studies in a woman with severe postpartum preeclampsia complicated by reversible cortical blindness showed that blindness resulted from vasogenic (hydrostatic) cerebral edema and not cerebral vasospasm.

摘要

背景

皮质盲是重度子痫前期的一种并发症,但尚不清楚其是由脑血管痉挛和缺血性损伤引起,还是由于毛细血管通透性增加导致的血管源性(静水压性)水肿所致。

病例

本文报告了一名33岁、孕2产1的患者,在妊娠19周行部分性葡萄胎清宫术后发生严重产后子痫前期,出现可逆性皮质盲。最初的神经影像学检查显示头部单光子发射计算机断层扫描有血流灌注增加,这与头部计算机断层扫描和磁共振成像扫描发现的病变相符。2周后的随访神经影像学检查显示,此时患者视力已恢复正常,影像学异常完全消失。

结论

对一名患有严重产后子痫前期并伴有可逆性皮质盲的女性进行的神经影像学研究表明,失明是由血管源性(静水压性)脑水肿而非脑血管痉挛所致。

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