Takahashi M, Abe K, Fujimura H, Yorifuji S, Tarui S
Department of Neurology, Osaka University Medical School.
Rinsho Shinkeigaku. 1991 May;31(5):554-6.
We reported a 15-year-old male patient of subacute sclerosing panencephalitis (SSPE), progressed from stage I to stage IV. On his admission, his clinical state was stage I with disturbance of generalized attention, myoclonus of upper limbs and no focal cortical signs. After rapid progression to stage III in a month, his clinical state became fairly stable and gradually advanced to stage IV. We followed him with serial CT and MR images. On imagings we found initial lesion in left parietoocipital lobe and spread in right parietoocipital lobe, anterior lobe and then brain stem, showing low density on plain CT scans and high intensity of T2 weighed MR images. This initial lesion situated in watershed area was hardly distinguishable from watershed infarction. In addition, we found blood flow decrease in vertebral artery system with SPECT and Doppler flowmetry. These findings suggested vascular pathogenesis of SSPE. We showed the imaging processes of SSPE progression from formation of initial lesion to demyelination and gliosis of total brain.
我们报告了一名15岁的亚急性硬化性全脑炎（SSPE）男性患者，病情从I期进展到IV期。入院时，其临床状态为I期，有注意力不集中、上肢肌阵挛，无局灶性皮质体征。在1个月内迅速进展至III期后，其临床状态变得相当稳定，并逐渐发展到IV期。我们通过系列CT和MR图像对他进行随访。在影像学检查中，我们发现最初的病变位于左顶枕叶，然后扩散至右顶枕叶、额叶，进而累及脑干，在CT平扫上显示为低密度，在T2加权MR图像上显示为高信号。这个位于分水岭区的初始病变很难与分水岭梗死区分开来。此外，我们通过SPECT和多普勒血流仪发现椎动脉系统血流减少。这些发现提示了SSPE的血管发病机制。我们展示了SSPE从初始病变形成到全脑脱髓鞘和胶质增生的进展过程中的影像学表现。
