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颅内动脉瘤弹簧圈栓塞术后单侧可逆性后部白质脑病综合征

Unilateral reversible posterior leukoencephalopathy syndrome after coiling of an aneurysm.

机构信息

Department of Neurology, MCH Westeinde Hospital, The Hague, The Netherlands.

出版信息

J Clin Neurol. 2014 Jan;10(1):59-63. doi: 10.3988/jcn.2014.10.1.59. Epub 2014 Jan 6.

DOI:10.3988/jcn.2014.10.1.59
PMID:24465265
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3896651/
Abstract

BACKGROUND

Reversible posterior leukoencephalopathy syndrome (RPLS) is radiologically characterized by symmetrical subcortical areas of vasogenic edema that are preferentially parieto-occipital, and it typically resolves after appropriate treatment.

CASE REPORT

We present a patient with strikingly unilateral RPLS that developed 21 days after coiling of an anterior communicating artery aneurysm and several days of triple-H therapy. Cortical and subcortical vasogenic edema and enhancement developed only in the left hemisphere, with a pattern suggesting RPLS. After 7 months the lesions had nearly completely resolved.

CONCLUSIONS

The pathophysiological mechanism underlying RPLS is still not well understood, which makes it difficult to explain the unilateral appearance in this case. Since the imaging findings may be confused with other conditions such as ischemia, recognition of RPLS after coiling is necessary in order to avoid inadequate treatment.

摘要

背景

可逆性后部脑白质病综合征（RPLS）的影像学特征为皮质下区域血管源性水肿呈对称性，多位于顶枕叶，经适当治疗后可缓解。

病例报告

我们报告了一例患者，其在接受前交通动脉瘤弹簧圈栓塞术和三联 H 治疗数天后，出现了单侧 RPLS，且表现十分显著。皮质和皮质下血管源性水肿和强化仅发生在左侧半球，呈 RPLS 表现。7 个月后，病变几乎完全消退。

结论

RPLS 的病理生理机制尚不清楚，因此难以解释本例的单侧表现。由于影像学表现可能与其他疾病如缺血混淆，因此在弹簧圈栓塞术后应认识到 RPLS 的存在，以避免治疗不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8426/3896651/d839eba64dd5/jcn-10-59-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8426/3896651/4b638269f822/jcn-10-59-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8426/3896651/d4a8090c3d68/jcn-10-59-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8426/3896651/a18aa8d3af6d/jcn-10-59-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8426/3896651/d839eba64dd5/jcn-10-59-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8426/3896651/4b638269f822/jcn-10-59-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8426/3896651/d4a8090c3d68/jcn-10-59-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8426/3896651/a18aa8d3af6d/jcn-10-59-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8426/3896651/d839eba64dd5/jcn-10-59-g004.jpg

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