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[自身免疫性疾病中的后部可逆性脑病综合征]

[Posterior reversible encephalopathy syndrome in autoimmune disorders].

作者信息

Koltsov I A, Shchukin I A, Fidler M S, Yasamanova A N, Aryasova I K, Boiko A N

机构信息

Pirogov Russian National Research Medical University, Moscow, Russia.

Federal Center of Brain Research and Neurotechnologies, Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2024;124(7. Vyp. 2):50-57. doi: 10.17116/jnevro202412407250.

Abstract

Posterior reversible encephalopathy syndrome (PRES) is characterized by nonspecific symptoms, including not only pronounced non-focal and various focal neurological signs but also specific neuroimaging features, including vasogenic edema affecting predominantly the posterior area. PRES usually develops in the setting of acute arterial hypertension. However, it is not uncommon for PRES to develop in non-hypertensive patients, including people with autoimmune disorders (multiple sclerosis, neuromyelitis optica spectrum disorder, etc). PRES could also be due to the toxic effects of drugs or other substances. The pathophysiological mechanisms of PRES include impaired autoregulation of cerebral blood flow due to acute arterial hypertension and toxic endotheliotropic effects of endogenous and exogenous factors.

摘要

后部可逆性脑病综合征(PRES)的特征为非特异性症状,不仅包括明显的非局灶性和各种局灶性神经体征,还包括特定的神经影像学特征,如主要影响后部区域的血管源性水肿。PRES通常在急性动脉高血压的情况下发生。然而,PRES在非高血压患者中也不少见,包括患有自身免疫性疾病(多发性硬化症、视神经脊髓炎谱系障碍等)的患者。PRES也可能是由于药物或其他物质的毒性作用所致。PRES的病理生理机制包括急性动脉高血压导致的脑血流自动调节受损以及内源性和外源性因素的毒性内皮嗜性作用。

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