脊髓亚急性联合变性合并维生素 B12 缺乏相关性脑积水。
Subacute Combined Degeneration of the Spinal Cord and Hydrocephalus Associated with Vitamin B12 Deficiency.
机构信息
Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China.
Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China.
出版信息
World Neurosurg. 2019 Aug;128:277-283. doi: 10.1016/j.wneu.2019.05.008. Epub 2019 May 10.
BACKGROUND
This study aimed to report the case of a patient who presented with depression, cognitive impairment, ataxic gait, and urinary incontinence associated with vitamin B12 deficiency.
CASE DESCRIPTION
Serum vitamin B12 level was low in this patient, and anti-intrinsic factor antibody was positive. Neuroimaging revealed abnormal hyperintense signals in the cerebellum and dorsal and lateral columns of the spinal cord, and obstructive hydrocephalus. A biopsy of the stomach revealed chronic gastritis, intestinal metaplasia, and atrophy. After 3 months of initiating methylcobalamin therapy, significant improvement was noticed clinically, and brain magnetic resonance imaging was near to normal.
CONCLUSIONS
This study was novel in reporting subacute combined degeneration of the spinal cord and hydrocephalus associated with vitamin B12 deficiency in adults.
背景
本研究旨在报告一例维生素 B12 缺乏症患者，其表现为抑郁、认知障碍、共济失调步态和尿失禁。
病例描述
该患者血清维生素 B12 水平较低，抗内因子抗体阳性。神经影像学显示小脑和脊髓背侧及外侧柱异常高信号，且存在梗阻性脑积水。胃活检显示慢性胃炎、肠上皮化生和萎缩。开始使用甲钴胺治疗 3 个月后，临床症状显著改善，脑部磁共振成像接近正常。
结论
本研究报告了一例成人维生素 B12 缺乏症相关的亚急性联合变性和脊髓积水，这在之前的研究中较为少见。
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