Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida.
Multidisciplinary Epidemiology and Translational Research in Intensive Care, Emergency and Perioperative Medicine (METRIC), Mayo Clinic, Rochester, Minnesota.
Semin Neurol. 2021 Aug;41(4):447-452. doi: 10.1055/s-0041-1726285. Epub 2021 Apr 13.
Neurological complications after heart transplantation are common and include cerebrovascular events (ischemic strokes, hemorrhagic strokes, and transient ischemic attacks), seizures, encephalopathy, central nervous system (CNS) infections, malignancies, and peripheral nervous system complications. Although most neurological complications are transient, strokes and CNS infections can result in high mortality and morbidity. Early recognition and timely management of these serious complications are crucial to improve survival and recovery. Diagnosing CNS infections can be challenging because their clinical presentation can be subtle in the setting of immunosuppression. Immunosuppressive medications themselves can cause a broad spectrum of neurological complications including seizures and posterior reversible encephalopathy syndrome. This article provides a review of the diagnosis and management of neurological complications after cardiac transplantation.
心脏移植后的神经系统并发症很常见，包括脑血管事件（缺血性中风、出血性中风和短暂性脑缺血发作）、癫痫、脑病、中枢神经系统（CNS）感染、恶性肿瘤和周围神经系统并发症。虽然大多数神经系统并发症是短暂的，但中风和 CNS 感染可导致高死亡率和发病率。早期识别和及时治疗这些严重并发症对于提高生存率和恢复至关重要。由于免疫抑制，中枢神经系统感染的临床表现可能不明显，因此诊断具有挑战性。免疫抑制药物本身可引起广泛的神经系统并发症，包括癫痫发作和后部可逆性脑病综合征。本文综述了心脏移植后神经系统并发症的诊断和治疗。
