Hori A, Hirose G, Kataoka S, Tsukada K, Tonami H
Department of Neurology and Radiology, Kanazawa Medical University.
Rinsho Shinkeigaku. 1990 Jul;30(7):731-7.
A 13-year-old boy was the victim of a strangulation attempt. His behavior was normal by the 6th day after the assault. However, from the 7th day, he developed choreoathetosis, dystonia and marked pseudobulbar palsy. CT and T2-weighted MRI at this time revealed a low density and high signal intensity in the region of the bilateral putamen and caudate respectively for the first time. Thereafter, these symptoms and changes in CTs and MRIs subsided gradually over two months. Sequential analysis of CSF for GABA and dopamine during illness revealed reciprocal changes each other with normal recovery. Because of delayed onset of neurological changes, and findings of CSF with reversible symptoms the delayed encephalopathy after strangulation is probably related to biochemical alteration secondary to anoxia in vulnerable basal ganglia.
一名13岁男孩曾是勒颈未遂的受害者。袭击后第6天他的行为正常。然而,从第7天起,他出现了舞蹈手足徐动症、肌张力障碍和明显的假性延髓麻痹。此时的CT和T2加权MRI首次分别显示双侧壳核和尾状核区域低密度和高信号强度。此后,这些症状以及CT和MRI的变化在两个月内逐渐消退。患病期间对脑脊液进行的GABA和多巴胺的连续分析显示,随着恢复正常,二者呈现相互变化。由于神经学变化出现延迟,以及脑脊液检查发现症状可逆,绞窄后迟发性脑病可能与易损基底神经节缺氧继发的生化改变有关。