Phan Mimi N, Nakawah Mohammad Obadah
College of Medicine, Texas A&M Health Science Center, Houston, Texas.
Department of Neurology, Houston Methodist Neurological Institute, Houston, Texas.
Proc (Bayl Univ Med Cent). 2020 Jul 16;33(4):679-680. doi: 10.1080/08998280.2020.1778423.
Delayed posthypoxic leukoencephalopathy is a rare condition that can occur following prolonged cerebral hypo-oxygenation and manifests as acute onset of neuropsychiatric symptoms after a period of apparent recovery. We describe a case of a 76-year-old man who presented after an unwitnessed fall of unknown duration with initial recovery followed by progressive neurocognitive decline resulting in dementia, dysphasia, and gait apraxia. Initial brain magnetic resonance imaging was unremarkable but repeated brain imaging revealed progressive leukoencephalopathy, which started as small foci of abnormal diffusion restriction in bilateral frontal lobes and gradually evolved over the next 3 weeks to diffuse signal changes in the white matter.
迟发性缺氧后白质脑病是一种罕见的疾病,可发生于长时间脑缺氧之后,表现为在一段明显恢复后急性起病的神经精神症状。我们报告一例76岁男性病例,该患者在未被目睹的、持续时间不明的跌倒后就诊,最初有恢复,随后出现进行性神经认知功能下降,导致痴呆、失语和步态失用。最初的脑部磁共振成像未见明显异常,但重复脑部成像显示进行性白质脑病,开始表现为双侧额叶小的异常弥散受限灶,在接下来的3周内逐渐演变为白质弥漫性信号改变。