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大脑过度灌注综合征及相关情况。

Cerebral Hyperperfusion Syndrome and Related Conditions.

机构信息

Neurology Department, Central University Hospital of Asturias, Oviedo, Spain,

Neurology Department, Clinique Valmont, Montreux, Switzerland.

出版信息

Eur Neurol. 2020;83(5):453-457. doi: 10.1159/000511307. Epub 2020 Oct 16.

Abstract

Cerebral vasoconstriction is a normal physiological response under determined conditions to preserve a normal cerebral blood flow. However, there are several syndromes, with impaired cerebral autoregulation and cerebral vasoconstriction, not related with infection or inflammation, which share the same radiological and clinical presentation. We review here the cerebral hyperperfusion syndrome and related conditions such as hypertensive encephalopathy, posterior reversible encephalopathy syndrome, and reversible cerebral vasoconstriction syndrome. These syndromes might share the same pathophysiological mechanism with endothelial damage, cerebral vasoconstriction, blood-brain barrier disturbance, cerebral edema, and, occasionally, intracerebral hemorrhage, with fatal cases described in all. Despite knowledge of these syndromes, they still remain unknown to us. Why these entities present in some patients and not in others goes further than the actual understanding of these diseases. We have to consider that a genetic susceptibility and molecular disturbances may be involved. Thus, more studies are needed in order to better characterize such syndromes.

摘要

脑血管收缩是在特定条件下保持正常脑血流的正常生理反应。然而,有几种综合征存在脑自动调节和脑血管收缩受损,与感染或炎症无关,但具有相同的放射学和临床表现。在这里,我们复习了脑高灌注综合征以及相关疾病,如高血压脑病、可逆性后部脑病综合征和可逆性脑血管收缩综合征。这些综合征可能具有相同的病理生理机制,包括内皮损伤、脑血管收缩、血脑屏障障碍、脑水肿,偶尔还会出现脑出血,所有这些都会导致致命病例。尽管对这些综合征有了一定的认识,但我们仍然对它们知之甚少。为什么这些疾病在某些患者中出现而在另一些患者中不出现,这不仅仅是对这些疾病的实际认识。我们必须考虑到遗传易感性和分子紊乱可能涉及其中。因此,需要进一步开展更多的研究以更好地描述这些综合征。

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