Shibata Haruto, Uchida Yuto, Kobayashi Shin, Takada Koji, Ikegami Yukihiro, Matsukawa Noriyuki
Department of Neurology, Toyokawa City Hospital.
Department of Neurology, Nagoya City University Graduate School of Medicine.
Rinsho Shinkeigaku. 2020 Dec 26;60(12):857-860. doi: 10.5692/clinicalneurol.cn-001455. Epub 2020 Nov 20.
A 63-year-old man was admitted to our hospital with a 2-month history of anxiety. He presented with cognitive impairment and muscle weakness. On MRI, T-weighted images showed longitudinally extensive spinal cord lesion (LESCL) from C2 to T6 and gadolinium-enhanced T-weighted images showed fan-shaped multiple linear enhancements converging to the lateral ventricles. He was diagnosed as primary central nervous system vasculitis (PCNSV) by brain biopsy. After using high dose corticosteroids, cognitive impairment and muscle weakness were dramatically improved. In patients with cognitive impairment, PCNSV should be included in the differential diagnosis of LESCL.
一名63岁男性因焦虑2个月入院。他表现出认知障碍和肌肉无力。MRI检查显示，T加权图像显示从C2至T6的纵向广泛脊髓病变（LESCL），钆增强T加权图像显示扇形多个线性强化并汇聚至侧脑室。经脑活检，他被诊断为原发性中枢神经系统血管炎（PCNSV）。使用大剂量皮质类固醇后，认知障碍和肌肉无力显著改善。对于有认知障碍的患者，PCNSV应纳入LESCL的鉴别诊断。
