神经结节病中的烟雾病样血管病变
Moyamoya-like vasculopathy in neurosarcoidosis.
作者信息
Ko Jun Kyeung, Lee Sang Weon, Choi Chang Hwa
机构信息
Department of Neurosurgery, School of Medicine, Pusan National University, Busan, Korea.
出版信息
J Korean Neurosurg Soc. 2009 Jan;45(1):50-2. doi: 10.3340/jkns.2009.45.1.50. Epub 2009 Jan 31.
A 31-year-old man presented with dull headache and memory disturbance lasting for one week. Computed tomographic scans revealed acute hydrocephalus. The cerebrospinal fluid contained 53 leukocytes/mm(3), with a mononuclear preponderance and no erythrocytes. Magnetic resonance imaging revealed hydrocephalus and leptomeningeal enhancement. Magnetic resonance angiography and digital subtraction angiography showed supraclinoid occlusion of the right internal carotid artery, which resembled unilateral moyamoya disease. Neuroendoscopic biopsy of a lesion in the septum pellucidum revealed noncaseating granulomas, which was consistent with sarcoidosis. The patient was successfully managed with intravenous methylprednisolone and ventriculoperitoneal shunting. To our knowledge, this is the first case of moyamoya-like vasculopathy associated with neurosarcoidosis.
一名31岁男性出现持续一周的钝痛性头痛和记忆障碍。计算机断层扫描显示急性脑积水。脑脊液中白细胞计数为53个/mm³，以单核细胞为主，无红细胞。磁共振成像显示脑积水和软脑膜强化。磁共振血管造影和数字减影血管造影显示右侧颈内动脉床突上段闭塞，类似单侧烟雾病。透明隔病变的神经内镜活检显示非干酪样肉芽肿，符合结节病。该患者通过静脉注射甲泼尼龙和脑室腹腔分流术成功治疗。据我们所知，这是首例与神经结节病相关的烟雾病样血管病变病例。
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