Miyamura Masanori, Matsumoto Katsuhisa, Takahashi Yu, Matsumoto Naoki
Department of Neurology, Ise General Hospital, 3038 Kusube-cho, Ise-shi, Mie 516 0014, Japan.
Brain Nerve. 2007 Nov;59(11):1283-6.
A 71-year-old female was suffered from acute mountain sickness at an altitude of about 3,700 m. and became comatose. Although the patient recovered from the symptom after coming down from the mountain, family members and friends began to notice her personality changes in daily life. She became apathetic, uncommunicative, expressionless, less interested in hobbies and less sociable and was pointed it out by them. In neurological images, MRI revealed localized lesions at the globus pallidus, bilaterally. It was conjectured that pallidal lesions caused by hypobaric hypoxia at high elevation in the case induced neurobehavioral syndrome (globus pallidus syndrome) similar to the frontal lobe syndrome by way of the frontal-subcortical circuits. As, in recent years, the transportation to high ground has become relatively easy for the elderly, it is feared that the incidence of acute mountain sickness may increase. In acute mountain sickness, while neurological symptoms at the acute phase, such as headache, consciousness disturbances and ataxia, are emphasized, it is necessary, in examination of patients who recovered from acute symptoms, to recognize the presence of executive dysfunction as aftereffect, as seen in the present case.
一名71岁女性在海拔约3700米处患上急性高原病并昏迷。尽管患者下山后症状有所恢复，但家人和朋友开始注意到她在日常生活中的性格变化。她变得冷漠、不爱交流、面无表情，对爱好的兴趣减少，社交能力下降，这些都被他们指了出来。在神经影像学检查中，磁共振成像（MRI）显示双侧苍白球有局部病变。据推测，该病例中因高海拔低压缺氧导致的苍白球病变通过额叶 - 皮质下回路引发了类似于额叶综合征的神经行为综合征（苍白球综合征）。近年来，老年人前往高地的交通相对便利，因此担心急性高原病的发病率可能会增加。在急性高原病中，虽然急性期的神经症状如头痛、意识障碍和共济失调受到关注，但对于从急性症状中恢复的患者进行检查时，有必要认识到如本病例所示的执行功能障碍后遗症的存在。
