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脑灌注成像评估血管内激光光疗对一氧化碳中毒后迟发性神经后遗症的影响:一例报告并文献复习

Effects of intravascular laser phototherapy on delayed neurological sequelae after carbon monoxide intoxication as evaluated by brain perfusion imaging: A case report and review of the literature.

作者信息

Liu Chuan-Ching, Hsu Chun-Sheng, He Hsin-Chen, Cheng Yuan-Yang, Chang Shin-Tsu

机构信息

Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung 407, Taiwan.

出版信息

World J Clin Cases. 2021 May 6;9(13):3048-3055. doi: 10.12998/wjcc.v9.i13.3048.

Abstract

BACKGROUND

Delayed neurological sequelae (DNS) caused by carbon monoxide (CO) intoxication poses considerable treatment challenges for clinical practitioners. In this report, we used nuclear medicine imaging and the Mini-Mental State Examination (MMSE) to evaluate the effectiveness of intravascular laser irradiation of blood (ILIB) therapy for the management of DNS.

CASE SUMMARY

A 51-year-old woman presented to our medical center experiencing progressive bradykinesia, rigidity of limbs, gait disturbance, and cognitive impairment. Based on her neurological deficits, laboratory tests and imaging findings, the patient was diagnosed with delayed neurological sequelae of CO intoxication. She received intensive rehabilitation and ILIB therapy during 30 sessions over 2 mo after diagnosis. Brain single-photon emission computed tomography was performed both prior to and after ILIB therapy. The original hypoperfusion area in bilateral striata, bilateral frontal lobe, right parietal lobe, and bilateral cerebellum showed considerable improvement after completion of therapy. The patient's MMSE score also increased markedly from 6/30 to 25/30. Symptoms of DNS became barely detectable, and the woman was able to carry out her daily living activities independently.

CONCLUSION

ILIB therapy could facilitate recovery from delayed neurological sequelae in patients with CO intoxication, as demonstrated by improved cerebral blood flow and functional outcomes in our patient.

摘要

背景

一氧化碳(CO)中毒所致的迟发性神经后遗症(DNS)给临床医生带来了巨大的治疗挑战。在本报告中,我们使用核医学成像和简易精神状态检查表(MMSE)来评估血管内激光照射血液(ILIB)疗法对DNS的治疗效果。

病例摘要

一名51岁女性因进行性运动迟缓、肢体僵硬、步态障碍和认知障碍前来我院就诊。根据其神经功能缺损、实验室检查和影像学检查结果,该患者被诊断为CO中毒迟发性神经后遗症。诊断后2个月内,她接受了30次强化康复治疗和ILIB治疗。在ILIB治疗前后均进行了脑单光子发射计算机断层扫描。治疗结束后,双侧纹状体、双侧额叶、右侧顶叶和双侧小脑原有的灌注不足区域有显著改善。患者的MMSE评分也从6/30显著提高到25/30。DNS症状几乎无法察觉,该女性能够独立进行日常生活活动。

结论

正如我们患者的脑血流和功能结果改善所示,ILIB疗法有助于CO中毒患者迟发性神经后遗症的恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bef/8080739/9e8edd5c610a/WJCC-9-3048-g001.jpg

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