Crespin J, Nemcek A, Rehkemper G, Blei A T
Department of Medicine, Northwestern Memorial Hospital and Northwestern University, Chicago, Illinois 60611, USA.
Am J Gastroenterol. 2000 Jun;95(6):1568-71. doi: 10.1111/j.1572-0241.2000.02096.x.
Intrahepatic shunts are rarely diagnosed as a cause of neurocognitive abnormality. A complaint of fatigue led to the diagnosis of a right portal vein-hepatic vein aneurysmal communication in a 23-yr-old, otherwise healthy woman. Neuropsychological testing, imaging, and MR spectroscopy revealed changes similar to those described in patients with cirrhosis and subclinical hepatic encephalopathy. T1-weighted MRI showed a hyperintense globus pallidus, a feature seen in subjects with and without portal-encephalopathy. Portal-systemic shunting in the absence of parenchymal liver disease reproduces neurological features described in cirrhosis.
肝内分流很少被诊断为神经认知异常的原因。一名23岁、其他方面健康的女性因疲劳主诉而被诊断为右门静脉 - 肝静脉动脉瘤样交通。神经心理学测试、影像学检查和磁共振波谱显示出与肝硬化和亚临床肝性脑病患者中所描述的变化相似。T1加权磁共振成像显示苍白球高信号，这一特征在有或无门体性脑病的受试者中均可见。在无实质性肝病的情况下出现门体分流会重现肝硬化中所描述的神经学特征。
