Pernicone Elizabeth, Watal Pankaj, Dhar Deeksha, Hayes Laura L, Chandra Tushar
Medicine, University of Central Florida College of Medicine, Orlando, USA.
Pediatric Radiology, Nemours Children's Hospital, Orlando, USA.
Cureus. 2020 Sep 22;12(9):e10583. doi: 10.7759/cureus.10583.
A school-age boy with a complex medical history underwent a minor elective surgical procedure. Propofol was used for sedation during the procedure. The patient could not be awakened post-operatively. Laboratory findings demonstrated metabolic lactic acidosis, leukocytosis with bandemia, and transaminitis. Neuroimaging demonstrated findings that were consistent with hypoxic-ischemic or toxic-metabolic brain injury involving the bilateral basal ganglia, hippocampi, and cerebellum. The patient's condition progressively worsened over the course of the following few weeks, and brain death was confirmed by scintigraphy seven weeks later. Prompt neuroimaging in unresponsive patients with suspected propofol infusion syndrome (PRIS) is of critical importance in detecting neurologic injuries, excluding alternative diagnoses, and determining prognostication.
一名有复杂病史的学龄男孩接受了一次小型择期外科手术。术中使用丙泊酚进行镇静。术后患者无法苏醒。实验室检查结果显示代谢性乳酸酸中毒、伴有核左移的白细胞增多症和转氨酶升高。神经影像学检查结果与涉及双侧基底神经节、海马体和小脑的缺氧缺血性或中毒代谢性脑损伤一致。在接下来的几周里，患者的病情逐渐恶化，七周后通过闪烁扫描确认脑死亡。对于疑似丙泊酚输注综合征（PRIS）的无反应患者，及时进行神经影像学检查对于检测神经损伤、排除其他诊断以及确定预后至关重要。
