Horioka Kohei, Kinoshita Ikuo, Ohtsubo Mayumi, Wakiyama Harumi
Department of Internal Medicine, Nagasaki Genbaku Hospital.
Rinsho Shinkeigaku. 2007 Aug;47(8):526-9.
A 40-year-old woman noticed blurred vision of the right eye. The optic disc edema of bilateral eyegrounds was noted, and brain MRI showed abnormal signals of the brainstem at a neurosurgical clinic. On her first visit, blood pressure was as remarkably high as 250/130 mmHg. Neurologically, only optic disc edema of bilateral eye-grounds was found. Both T2-weighted MRI and FLAIR showed hyperintense signal areas mainly from the ventral pons to medulla oblongata. These areas were not enhanced with gadolinium. About three weeks after the administration of an antihypertensive agent, brain MRI revealed no abnormal signal. About three months later, the blurred vision disappeared and ophthalmological abnormalities subsided. We diagnosed her with a brainstem variant of RPLS, presenting with visual disturbance caused by hypertensive retinopathy.
一名40岁女性注意到右眼视力模糊。在神经外科诊所检查发现双侧眼底视盘水肿,脑部MRI显示脑干有异常信号。初诊时,她的血压高达250/130 mmHg。神经系统检查仅发现双侧眼底视盘水肿。T2加权MRI和液体衰减反转恢复序列(FLAIR)均显示主要从脑桥腹侧至延髓的高信号区域。这些区域钆剂增强扫描无强化。使用降压药约三周后,脑部MRI未显示异常信号。约三个月后,视力模糊消失,眼科异常体征消退。我们诊断她为可逆性后部白质脑病综合征(RPLS)的脑干变异型,由高血压性视网膜病变导致视力障碍。