Uchiyama Taku, Okamoto Hiroaki, Koguchi Motofumi, Ogata Atsushi, Suzuyama Kenji, Matsushima Toshio
Department of Neurosurgery, Karatsu Red Cross Hospital.
No Shinkei Geka. 2013 Aug;41(8):697-702.
A 29-year-old woman complained of headache and nausea several hours after delivery, followed by mild disturbance of consciousness. Physical examination revealed hypertension, systemic edema, nystagmus, dysarthria, and cerebellar ataxia. Computed tomography showed low attenuation areas in the cerebellum, and MR imaging revealed vasogenic edema in the cerebellum. MR angiography and MR venography demonstrated no significant abnormalities. We diagnosed a cerebellar variant of posterior reversible encephalopathy syndrome(PRES), and treated the patient immediately with antihypertensive drug and diuretic. The symptoms dramatically improved and MR imaging ten days after admission revealed disappearance of the vasogenic edema in the cerebellum. She was discharged without any sequelae. Though a cerebellar variant of PRES is very rare, rapid diagnosis and treatment is important for good prognosis when the disease is encountered.
一名29岁女性在分娩后数小时出现头痛和恶心，随后出现轻度意识障碍。体格检查发现高血压、全身性水肿、眼球震颤、构音障碍和小脑共济失调。计算机断层扫描显示小脑有低密度区，磁共振成像显示小脑有血管源性水肿。磁共振血管造影和磁共振静脉造影未显示明显异常。我们诊断为后可逆性脑病综合征（PRES）的小脑变异型，并立即用抗高血压药物和利尿剂对患者进行治疗。症状显著改善，入院十天后的磁共振成像显示小脑血管源性水肿消失。她出院时没有任何后遗症。虽然PRES的小脑变异型非常罕见，但遇到这种疾病时，快速诊断和治疗对良好的预后很重要。
