Chen Hao, Li Hengyu, Li Yuncheng, Jing Jia, Raza Hafiz Khuram, Zhang Zuohui, Dong Liguo, Ye Xinchun, Hua Fang, Cui Guiyun
a Department of Neurology , the Affiliated Hospital of Xuzhou Medical University , Xuzhou , PR China.
b Department of Biology , Georgia State University , Atlanta , GA , USA.
Somatosens Mot Res. 2018 Jun;35(2):119-123. doi: 10.1080/08990220.2018.1484353. Epub 2018 Aug 15.
To report five cases of subacute combined degeneration (SCD) with brain involvement and explore its clinical and imaging characteristics.
A retrospective study was performed on the clinical data and brain MRI of five patients with subacute combined degeneration with brain involvement (out of 107 cases with SCD in total). White matter lesions (WML) assessment was performed qualitatively using Fazekas scale score.
The main symptoms in four patients were weakness in both lower extremities and unstable walking (limb weakness in three patients, dizziness in three patients, and blurred vision in one patient). One patient had memory loss and cognitive dysfunction. The MMSE scale indicated mild dementia in one patient. On head MRI (Magnetic Resonance Imaging), multifocal and symmetrical high signals of T2WI and FLAIR were observed in the frontal lobe and periventricular white matter in four patients, while another patient showed preferential atrophy in frontal regions. Fazekas scale scores ranged from 1-6.
Adult subacute combined degeneration seldom involves the brain. Multifocal and symmetrical high signal white matter lesions can be found on FLAIR and T2WI, as well as frontal atrophy on head MRI.
报告5例合并脑受累的亚急性联合变性（SCD）病例，并探讨其临床及影像学特征。
对5例合并脑受累的亚急性联合变性患者（共107例SCD患者）的临床资料及脑部磁共振成像（MRI）进行回顾性研究。采用Fazekas量表评分对脑白质病变（WML）进行定性评估。
4例患者的主要症状为双下肢无力及行走不稳（3例肢体无力，3例头晕，1例视力模糊）。1例患者有记忆力减退及认知功能障碍。简易精神状态检查表（MMSE）显示1例患者有轻度痴呆。头部MRI（磁共振成像）检查显示，4例患者额叶及脑室周围白质在T2加权成像（T2WI）和液体衰减反转恢复序列（FLAIR）上呈多灶性、对称性高信号，另1例患者额叶出现萎缩。Fazekas量表评分范围为1 - 6分。
成人亚急性联合变性很少累及脑部。在FLAIR和T2WI上可发现多灶性、对称性高信号脑白质病变，头部MRI还可显示额叶萎缩。
