Cherkaoui Jaouad M R, Amrani C, Mahi M, Bouknani N
Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Bld Mohammed Taïeb Naciri, Commune Hay Hassani 82 403, Casablanca, Morocco.
Radiol Case Rep. 2022 Jul 29;17(10):3616-3619. doi: 10.1016/j.radcr.2022.06.095. eCollection 2022 Oct.
Our case report presents a patient with central pontine myelinolysis and arachnoidocele. He was hospitalized twice these 2 last months for a confusional syndrome associated to an alteration of his general health where metabolic disorders where found: a hyponatremia at 125 mmol/l that was quickly corrected and a hypoglycemia at 0.30 g/l. A central pontine myelinolysis was found as an iso-signal on T1-weighted sequences and a hypersignal on T2-weighted and FLAIR sequences on magnetic resonnance imaging. Central pontine myelinolysis lesions did not enhance with contrast. Incidental imaging findings of arachnoidocele was detected. Through this case, we would like to share with the other practitioners these rare images and the consequence of a diagnostic delay. Indeed, hyponatremia in our patient could be the consequence of the intrasellar arachnoidocele and the overly rapid correction of this chronic hyponatremia caused central pontine myelinolysis, or it is an accidental phenomenon where we found both lesions.
我们的病例报告介绍了一名患有中央桥脑髓鞘溶解症和蛛网膜囊肿的患者。在过去两个月里，他因与全身健康状况改变相关的意识模糊综合征住院两次，检查发现存在代谢紊乱：血钠浓度为125 mmol/L的低钠血症且迅速得到纠正，血糖浓度为0.30 g/L的低血糖症。磁共振成像显示，中央桥脑髓鞘溶解症在T1加权序列上呈等信号，在T2加权和液体衰减反转恢复序列上呈高信号。中央桥脑髓鞘溶解症病变在增强扫描时无强化。偶然发现了蛛网膜囊肿的影像学表现。通过这个病例，我们希望与其他从业者分享这些罕见的影像以及诊断延误的后果。事实上，我们患者的低钠血症可能是鞍内蛛网膜囊肿的结果，而这种慢性低钠血症的过度快速纠正导致了中央桥脑髓鞘溶解症，或者这是一种我们同时发现这两种病变的偶然现象。
