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一名艾滋病患者出现隐球菌性脑膜脑炎,伴有严重的局限性神经功能缺损,酷似右侧大脑中动脉大面积梗死。

Cryptococcus Meningoencephalitis With Severe Localizing Neurological Deficits Mimicking a Large Right Middle Cerebral Artery Infarct in a HIV Patient.

作者信息

Tahhan Fadi, Haritounian Argin, Duong Lisa, Haugen Jessica, Liu Antonio K

机构信息

Internal Medicine, Adventist Health White Memorial, Los Angeles, USA.

Neurology, Adventist Health White Memorial, Los Angeles, USA.

出版信息

Cureus. 2021 Apr 30;13(4):e14781. doi: 10.7759/cureus.14781.

Abstract

Immunocompromised patients with Cryptococcal meningoencephalitis can develop focal neurological signs and symptoms. Stroke and abscess are usually the leading etiologies. Definitively localized non-fluctuating deficits mimicking a large middle cerebral artery (MCA) infarct without corresponding MRI findings is rare. Localized lobar cerebritis may be the underlying etiology. Despite having many different kinds of sequences, a significant pathological process can still evade MRI's detection. Diffusion-weighted imaging (DWI) abnormality has also been seen in pathology other than ischemic stroke.

摘要

患有隐球菌性脑膜脑炎的免疫功能低下患者可能会出现局灶性神经体征和症状。中风和脓肿通常是主要病因。明确局限性、无波动的神经功能缺损,类似大脑中动脉(MCA)大面积梗死但无相应MRI表现的情况很少见。局限性脑叶脑炎可能是潜在病因。尽管有许多不同类型的序列,但重要的病理过程仍可能逃避MRI的检测。除缺血性中风外,扩散加权成像(DWI)异常在其他病理情况中也可见到。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2956/8093100/9e03132ea921/cureus-0013-00000014781-i01.jpg

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