Wang Jieru, Jian Tianzi, Yu Guangcai, Kan Baotian, Li Wei, Jian Xiangdong
Department of Critical Care Medicine, The 5th People's Hospital of Jinan, Jinan, Shandong, China.
Department of Poisoning and Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Front Toxicol. 2025 Jun 25;7:1557995. doi: 10.3389/ftox.2025.1557995. eCollection 2025.
1,2-Dichloroethane is a commonly used industrial solvent. Acute or subacute occupational exposure can cause toxic encephalopathy; however, long-term changes in brain imaging are not frequently documented.
A 39-year-old woman developed dizziness and forgetfulness 9 days after performing glue coating. Her symptoms improved significantly after a 7-day break from work. However, after resuming work for 3 days, she returned with dizziness, headache, and anxiety. Brain magnetic resonance imaging (MRI) showed extensive edema and diffuse abnormal signal intensities in the cerebellar dentate nucleus, basal ganglia, and bilateral cerebral white matter. She was treated with salvianolate injection, magnesium isoglycyrrhizinate, and neurotrophic therapy. Two weeks after admission, her symptoms improved significantly, except for mild uncoordinated walking. The range of abnormal MRI signals remained consistent with previous findings. She was discharged the following day. She experienced worsened headache 3 days later. Computed tomography revealed diffuse cerebral edema. Despite treatment with mannitol, her headache rapidly worsened and was accompanied by nausea, vomiting, hypertension, bradycardia, and dyspnea, ultimately leading to unconsciousness. Follow-up MRI showed findings similar to the previous scan, except that the apparent diffusion coefficient (ADC) sequence had changed from hypointense to hyperintense. Shortly after the MRI examination, she experienced respiratory arrest. Unfortunately, she died 32 days after her initial admission due to severe cerebral injury and infection.
Occupational exposure to 1,2-dichloroethane can lead to toxic encephalopathy, presenting as diffuse progressive cerebral edema. This case shows that brain imaging findings may not always correlate with the patient's clinical condition, so careful monitoring is essential.
1,2 - 二氯乙烷是一种常用的工业溶剂。急性或亚急性职业暴露可导致中毒性脑病；然而，脑成像的长期变化记录并不常见。
一名39岁女性在进行涂胶工作9天后出现头晕和健忘症状。休息7天后症状明显改善。然而，复工3天后，她再次出现头晕、头痛和焦虑症状。脑磁共振成像（MRI）显示小脑齿状核、基底神经节和双侧脑白质广泛水肿及弥漫性异常信号强度。给予丹参多酚酸盐注射液、异甘草酸镁和神经营养治疗。入院两周后，除轻度行走不协调外，她的症状明显改善。MRI异常信号范围与之前检查结果一致。次日出院。3天后她头痛加重。计算机断层扫描显示弥漫性脑水肿。尽管使用甘露醇治疗，她的头痛迅速加重，并伴有恶心、呕吐、高血压、心动过缓和呼吸困难，最终导致昏迷。随访MRI显示结果与之前扫描相似，只是表观扩散系数（ADC）序列从低信号变为高信号。MRI检查后不久，她出现呼吸骤停。不幸的是，她在首次入院32天后因严重脑损伤和感染死亡。
职业性接触1,2 - 二氯乙烷可导致中毒性脑病，表现为弥漫性进行性脑水肿。该病例表明脑成像结果可能并不总是与患者的临床状况相关，因此仔细监测至关重要。
