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研究后部可逆性脑病综合征(PRES)的临床放射学特征和转归。

To Study Clinicoradiological Profile and Outcome of Posterior Reversible Encephalopathy Syndrome (Pres).

机构信息

Gmch, Nagpur, Maharashtra.

出版信息

J Assoc Physicians India. 2022 Apr;70(4):11-12.

Abstract

UNLABELLED

Posterior reversible encephalopathy syndrome is potentially reversible clinicoradiological syndrome. In this study we explored potential, clinical and radiological presentation, risk factor and outcome of patient.

MATERIAL

We performed prospective observational study in 97 diagnosed cases of posterior reversible encephalopathy syndrome during period of 1st Aug 2019 to 4th Nov 2021 admitted in tertiary care unit of central India.Each and every patients detail history was noted, thorough clinical examination was done and every patient was subjected to investigation like CBC, LFT, KFT, Sr. LDH, Ionic Ca, Sr.Mg, ANA, Fundoscopy, MRI brain and CT head.

OBSERVATION

Of total 97 patients ; in our study there was female preponderance (M:F::1:18). The mean age of cases was 27.61 +/- 9.65 years. Most common symptoms were headache (77.32%) followed by seizure(65.98%), altered sensorium(53.61%), visual impairment(50.52%), vomiting (39.18), and hemiparesis(10.31%). Most common risk factor were Antepartum eclampsia (48.45 %) followed by Postpartum eclampsia(29.90 %), pre- eclampsia (16.49 %), systemic hypertension (6.19%), and renal diseases (3.09%). Radiologically most commonly affected lobe was occipital lobe (74.23%) followed by parietal lobe(56.70%), temporal lobe(42.27 %), frontal lobe (43.30 %), cerebellum (3.09%) and other (10.31%). Subcortical hypodensities (100%) was more common than cortical hypodensities (6.19%) other were haemorrhage (8.25%) and infarct (6.19%). Of 97 patient; 5 patient succumbed to death (5.15%) and 92 patient (94.85%) were discharged and followed during next few weeks ;of them 84 patient (91.30 %) showed clinical improvement, 72 patients were followed up for neuroimaging of which 68 (94.44%) patients showed radiologically improvement .Out of 8 patient who didn't show recovery, 4 had persistent weakness(hemiparesis),3 had visual impairment(diplopia) and 1 had persistent tremors at end of 12 weeks.

CONCLUSION

Posterior reversible encephalopathy syndrome (PRES) is mostly benign condition.It's clinicoradiological presentation, early recognition and management helps in speedy recovery and less morbidity in high risk patients.

摘要

背景

后部可逆性脑病综合征是一种潜在可逆转的临床影像学综合征。本研究旨在探讨该病的潜在病因、临床表现、危险因素和预后。

材料和方法

我们对 2019 年 8 月 1 日至 2021 年 11 月 4 日期间在印度中部三级护理中心住院的 97 例后部可逆性脑病综合征患者进行了前瞻性观察性研究。详细记录每位患者的病史,进行全面的临床检查,并进行包括全血细胞计数、肝功能、肾功能、血清乳酸脱氢酶、血清离子钙、血清镁、抗核抗体、眼底检查、脑部磁共振成像和头部 CT 在内的检查。

结果

在 97 例患者中,女性多于男性(1:18)。患者的平均年龄为 27.61±9.65 岁。最常见的症状是头痛(77.32%),其次是癫痫(65.98%)、意识改变(53.61%)、视力障碍(50.52%)、呕吐(39.18%)和偏瘫(10.31%)。最常见的危险因素是产前子痫(48.45%),其次是产后子痫(29.90%)、子痫前期(16.49%)、高血压(6.19%)和肾脏疾病(3.09%)。影像学上最常受累的脑叶是枕叶(74.23%),其次是顶叶(56.70%)、颞叶(42.27%)、额叶(43.30%)、小脑(3.09%)和其他部位(10.31%)。皮质下低信号(100%)比皮质低信号(6.19%)更常见,其他包括出血(8.25%)和梗死(6.19%)。97 例患者中,5 例死亡(5.15%),92 例(94.85%)出院并在接下来的几周内随访;其中 84 例(91.30%)患者临床症状改善,72 例患者进行神经影像学随访,其中 68 例(94.44%)患者影像学改善。8 例未恢复的患者中,4 例持续存在偏瘫,3 例存在复视,1 例在 12 周时仍存在震颤。

结论

后部可逆性脑病综合征(PRES)通常是一种良性疾病。其临床表现和影像学特征,早期识别和治疗有助于高危患者快速康复,降低发病率。

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