Children's Hospital, London Health Science Centre, London, ON, Canada.
Department of Medical Imaging, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Emerg Radiol. 2022 Dec;29(6):1055-1058. doi: 10.1007/s10140-022-02084-8. Epub 2022 Aug 10.
An increased awareness of opioids and the imaging appearance in opioid overdose-related leukoencephalopathy has rapidly become crucial with respect to its identification by emergency radiologists. It is a potentially life-threatening condition and is associated with devastating neurological outcomes. Thus, early diagnosis and management are paramount. We report a rare case of toxic leukoencephalopathy in a 20-month-old male patient secondary to morphine overdose in the outpatient setting following discharge from uncomplicated urethroplasty. Although pediatric toxic leukoencephalopathy has been reported previously in the literature, our case report is unique as it involves morphine, a less commonly used opioid in the outpatient setting. Moreover, we have provided brain computed tomography and magnetic resonance imaging and highlighted findings in the acute and chronic stages of the disease trajectory. This case report highlights the importance for radiologists, especially those involved in emergency care, to have a high index of suspicion for toxic leukoencephalopathy, a potentially devastating but treatable condition.
随着人们对阿片类药物的认识不断提高，以及在阿片类药物过量相关脑白质病中的影像学表现，急诊放射科医生对其进行识别变得至关重要。这种疾病可能危及生命，且与严重的神经后果相关。因此，早期诊断和治疗至关重要。我们报告了一例罕见的 20 个月大男性患者在门诊接受吗啡过量治疗后的毒蕈碱样脑白质病病例，该患者在接受单纯尿道成形术出院后出现吗啡中毒。尽管儿科毒蕈碱样脑白质病以前在文献中已有报道，但我们的病例报告很独特，因为它涉及到在门诊中使用较少的阿片类药物——吗啡。此外，我们还提供了脑 CT 和 MRI，并强调了疾病轨迹的急性和慢性阶段的发现。本病例报告强调了放射科医生，特别是参与急诊护理的放射科医生，对毒蕈碱样脑白质病具有高度怀疑的重要性，因为这种疾病虽然可能具有破坏性，但可以治疗。
