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持续性全身支持在重症新型冠状病毒肺炎2019后迟发性缺氧性脑白质病临床病程中的意义

Significance of Persistent Systemic Support in the Clinical Course of Delayed Post-hypoxic Leukoencephalopathy Following Severe Coronavirus Disease 2019.

作者信息

Kawasaki Juri, Mato Naoko, Fujii Hiroyuki, Miura Kumiko, Mashiko Takafumi, Katayama Shinshu, Yamanouchi Yoshitaka, Sato Miki, Takasaki Toshikazu, Takigami Ayako, Hisata Shu, Nunomiya Shin, Hagiwara Koichi, Maemondo Makoto

机构信息

Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Japan.

Department of Radiology, Jichi Medical University, Japan.

出版信息

Intern Med. 2024 Apr 15;63(8):1167-1172. doi: 10.2169/internalmedicine.1412-22. Epub 2024 Feb 1.

Abstract

A 45-year-old woman was hospitalized with severe coronavirus disease 2019 pneumonia. Following cytokine storm-induced multiorgan failure and lethal arrhythmia, the patient developed a sustained coma with flaccid quadriplegia. A cerebrospinal fluid examination excluded infectious and immunogenic encephalopathies, and diffusion-weighted magnetic resonance imaging demonstrated high-intensity areas in the white matter with a cortex-sparing distribution, suggesting delayed post-hypoxic leukoencephalopathy. As a result of intensive cardiopulmonary support for a month, the neurological function gradually recovered. Based on the reversible clinical course noted in this patient, accurate diagnosis and persistent medical approaches are important for the management of coronavirus disease 2019-related delayed post-hypoxic leukoencephalopathy.

摘要

一名45岁女性因严重的2019冠状病毒病肺炎住院。在细胞因子风暴引发多器官功能衰竭和致命性心律失常后,患者出现持续昏迷并伴有弛缓性四肢瘫。脑脊液检查排除了感染性和免疫原性脑病,弥散加权磁共振成像显示白质有高强度区域,呈皮质 sparing 分布,提示迟发性缺氧后白质脑病。经过一个月的强化心肺支持,神经功能逐渐恢复。基于该患者所观察到的可逆临床病程,准确诊断和持续的医疗措施对于2019冠状病毒病相关迟发性缺氧后白质脑病的管理很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4218/11081903/9be5e344de71/1349-7235-63-1167-g001.jpg

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