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假瘤样病变作为急性出血性白质脑炎(韦斯顿 - 赫斯特综合征)的一种表现。

Pseudotumoral lesion as a manifestation of acute hemorrhagic leukoencephalitis (Weston-Hurst syndrome).

作者信息

Arenas Ruben D, Hernandez Enrique S

机构信息

Unit of Clinical Neurology, Department of Medicine, School of Medicine, Universidad Nacional de Colombia, Ciudad Universitaria carrera 30 # 45-03, Bogotá 111321, Colombia; Grupo de Investigación en Neurología de la Universidad Nacional de Colombia - (Neurology Research Group of the Universidad nacional de Colombia ) NEUROUNAL, Bogotá, Colombia.

Unit of Clinical Neurology, Department of Medicine, School of Medicine, Universidad Nacional de Colombia, Ciudad Universitaria carrera 30 # 45-03, Bogotá 111321, Colombia; Grupo de Investigación en Neurología de la Universidad Nacional de Colombia - (Neurology Research Group of the Universidad nacional de Colombia ) NEUROUNAL, Bogotá, Colombia.

出版信息

Mult Scler Relat Disord. 2020 Nov;46:102583. doi: 10.1016/j.msard.2020.102583. Epub 2020 Oct 13.

Abstract

A case of acute hemorrhagic encephalomyelitis whose first manifestation was a pseudotumoral lesion in the corpus callosum is presented. The patient had an acute headache accompanied by visual hallucinations and subsequently developed convulsive status epilepticus. The initial CT scan showed a lesion with a pseudotumoral aspect in the splenius of the corpus callosum. Multiple microbleeds in the same location associated with vasogenic edema were seen in the MRI. A brain biopsy was necessary to obtain an accurate diagnosis. Corticosteroid management resulted in only a partial response. Weston Hurst syndrome is a variant of acute disseminated encephalomyelitis (ADEM) with an unfavorable prognosis.

摘要

本文报告一例急性出血性脑脊髓炎,其首发表现为胼胝体部的假瘤样病变。患者突发头痛并伴有视幻觉,随后发展为惊厥性癫痫持续状态。最初的CT扫描显示胼胝体压部有一个假瘤样病变。MRI显示同一部位有多个微出血灶并伴有血管源性水肿。需要进行脑活检以获得准确诊断。皮质类固醇治疗仅产生部分反应。韦斯顿·赫斯特综合征是急性播散性脑脊髓炎(ADEM)的一种变体,预后不良。

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