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弥漫性脑血管畸形:一例致死性病例报告。

Diffuse cerebral angiomatosis: a case report with fatal outcome.

机构信息

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Hospital Ángeles del Pedregal, Mexico City, Mexico.

出版信息

Br J Neurosurg. 2020 Oct;34(5):524-527. doi: 10.1080/02688697.2019.1567682. Epub 2019 Mar 4.

Abstract

Diffuse cerebral angiomatosis is a rare disorder of the brain and only 5 cases have been reported to date. We report a 16-year-old female patient who presented to the emergency department with seizures. The patient had no hereditary syndromes, no epistaxis, no skin lesions and no telangiectasia. There was no livedo reticularis. The ophthalmologic examination was within normal limits. Magnetic resonance angiography (MRA) showed multiple diffuse tortuous vessels all around the brain tissue and ventricular system. Brain CT showed multiple calcifications. Digital subtraction angiography (DSA) demonstrated multiple arteriovenous shunts and diffuse arteriovenous malformations (AVM) without a typical nidus, draining into dilated cerebral veins. Multimodal ultrasound showed increased flow velocities in all cerebral arteries. We report the case of a patient with diffuse cerebral angiomatosis. This is the third study in which hemodynamic indices were evaluated through transcranial Doppler. Unlike all other case reports our patient had a bad outcome with important disability, dementia and drug resistant epilepsy that lead to the patient's death.HighlightsDiffuse cerebral angiomatosis is a rare disorder of the brain and only 5 cases have been reported to date.Unlike all other case reports our patient had a bad outcome with disability, dementia and drug resistant epilepsy that lead to the patient's death.

摘要

弥漫性脑动静脉血管畸形是一种罕见的脑部疾病,迄今为止仅报告了 5 例。我们报告了一例 16 岁女性患者,因癫痫发作到急诊科就诊。该患者无遗传性综合征,无鼻出血、皮肤病变和毛细血管扩张,无网状青斑。眼科检查正常。磁共振血管造影(MRA)显示脑实质和脑室系统周围有多个弥漫性迂曲的血管。脑 CT 显示多处钙化。数字减影血管造影(DSA)显示多发性动静脉分流和弥漫性动静脉畸形(AVM),无典型病灶,引流至扩张的脑静脉。多模态超声显示所有大脑动脉的血流速度增加。我们报告了一例弥漫性脑动静脉血管畸形患者。这是第三项通过经颅多普勒评估血流动力学指标的研究。与所有其他病例报告不同,我们的患者预后不良,有残疾、痴呆和耐药性癫痫,导致患者死亡。

重点

弥漫性脑动静脉血管畸形是一种罕见的脑部疾病,迄今为止仅报告了 5 例。

与所有其他病例报告不同,我们的患者预后不良,有残疾、痴呆和耐药性癫痫,导致患者死亡。

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