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[线状硬皮病:神经症状、影像学表现及综述]

[Linear scleroderma en coup de sabre: neurological symptoms, images and review].

作者信息

Ruiz-Sandoval J L, Romero-Vargas S, Gutierrez-Aceves G A, Garcia-Navarro V, Bernard-Medina A G, Cerda-Camacho F, Riestra-Castaneda R, Gonzalez-Cornejo S

机构信息

Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico.

出版信息

Rev Neurol. 2005;41(9):534-7.

Abstract

INTRODUCTION

'Sword stroke' linear scleroderma, which is better known as linear scleroderma en coup de sabre (LSCS), is a rare disease with an uncertain causation that is characterised by progressive craniofacial focal atrophy and is, at least in part, different from Parry-Romberg syndrome (PRS).

CASE REPORTS

Here, we report on the cases of 3 patients with LSCS (2 females and 1 male, with a mean age of 40 years). The main neurological symptoms were headache and seizures. Although different alterations were observed in the X-ray images, they were all ipsilateral to the coup de sabre. Histopathological evidence for gliosis and mixed perivascular inflammatory infiltrate was found in the study of a biopsy specimen taken from one female. Cerebrovascular involvement was seen in another patient, as highlighted by the observation of an earlier subclinical cerebellar infarct and occlusion of the superior cerebellar artery in the absence of any other possible causation.

CONCLUSIONS

When it affects the central nervous system, the clinical and radiological presentation of LSCS is heterogeneous. Both the imaging studies carried out during the clinical control and the histopathological findings suggest a focal inflammatory process that can be progressive. The arterial involvement is probably due to a non-atherosclerotic, occlusive and chronic inflammatory disease of the peripheral vessels.

摘要

引言

“剑击伤”线状硬皮病,更广为人知的名称是剑击伤线状硬皮病(LSCS),是一种病因不明的罕见疾病,其特征为进行性颅面部局灶性萎缩,且至少在一定程度上与帕里 - 罗姆伯格综合征(PRS)不同。

病例报告

在此,我们报告3例LSCS患者(2例女性,1例男性,平均年龄40岁)的病例。主要神经症状为头痛和癫痫发作。尽管在X线图像中观察到不同改变,但均与剑击伤同侧。在对1例女性患者的活检标本研究中发现了胶质增生和血管周围混合性炎性浸润的组织病理学证据。在另1例患者中发现了脑血管受累,表现为观察到早期亚临床小脑梗死以及小脑上动脉闭塞,且无任何其他可能病因。

结论

当LSCS累及中枢神经系统时,其临床和影像学表现具有异质性。临床检查期间进行的影像学研究和组织病理学结果均提示存在可进展的局灶性炎症过程。动脉受累可能是由于外周血管的非动脉粥样硬化性、闭塞性慢性炎症性疾病所致。

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