Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea.
Department of Neurology, Samsung Noble County Medical Center, Yongin, Korea.
J Clin Neurol. 2014 Oct;10(4):367-70. doi: 10.3988/jcn.2014.10.4.367. Epub 2014 Oct 6.
Patients who develop horizontal and vertical saccadic palsy after cardiac surgery have rarely been described. Although most such patients exhibit distinct neurological deficits, their brain MRI findings are almost normal. In addition, functional neuroimaging of such patients has never been reported.
A 43-year-old woman with dysarthria, dysphagia, and horizontal and vertical saccadic palsy after cardiac surgery was followed up for about 6 years; serial brain MRIs has been performed during this period, including susceptibility-weighted imaging (SWI) and [(18)F]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET). Multiple microbleeds in the cerebral cortex, cerebellum, and brainstem, and glucose hypometabolism in the brainstem, cerebellum, and multiple cortical areas.
To the best of our knowledge, this is the first reported case of saccadic palsy after cardiac surgery with serial SWI and [(18)F]-FDG-PET performed to explore the possible cerebral lesions.
心脏手术后出现水平和垂直扫视性眼球运动障碍的患者很少见。尽管大多数此类患者表现出明显的神经功能缺损，但他们的脑部 MRI 检查结果几乎正常。此外，此类患者的功能神经影像学检查尚未有报道。
一名 43 岁女性，在心脏手术后出现构音障碍、吞咽困难和水平及垂直扫视性眼球运动障碍，我们对其进行了约 6 年的随访；在此期间进行了多次脑部 MRI 检查，包括磁敏感加权成像（SWI）和 [(18)F]-氟-2-脱氧-D-葡萄糖正电子发射断层扫描（FDG-PET）。大脑皮质、小脑和脑干存在多处微出血，以及脑干、小脑和多个皮质区的葡萄糖代谢低下。
据我们所知，这是首例心脏手术后出现扫视性眼球运动障碍的病例报道，对其进行了连续的 SWI 和 [(18)F]-FDG-PET 检查，以探索可能的脑部病变。
