Hamann K U, Shults W T, Hoyt W F
Klin Monbl Augenheilkd. 1978 Jan;172(1):94-9.
Progressive multifocal leukoencephalopathy (PML) is a viral illness affecting principally cerebral white matter of patients, who have diminished immunologic resistance. A patient is presented, whose initial complaint was blurred vision. Relentless progression over a period of seven months to left hemianopsia, prosopagnosia, alexia with agraphia and eventually cortical blindness was observed. Accompanying the visual impairment was a steady deterioration of mental function. Sequential computerized axial tomography defined low density lesions in the occipital white matter with sparing of the cortical ribbon. As hemianopsia progressed to cortical blindness, the scans confirmed the evolution of bilaterial occipital lesions. The diagnosis was made clinically and established on histological and cultural grounds. Computerized tomography seems to be valuable in diagnosis and monitoring progress of PML.
进行性多灶性白质脑病(PML)是一种主要影响免疫抵抗力下降患者脑白质的病毒性疾病。本文报告了一名患者,其最初的主诉为视力模糊。在七个月的时间里,病情持续进展,出现了左侧偏盲、面容失认症、失读伴失写症,最终发展为皮质盲。随着视力障碍的出现,精神功能也持续恶化。连续的计算机断层扫描显示枕叶白质有低密度病变,皮质带未受影响。随着偏盲发展为皮质盲,扫描结果证实双侧枕叶病变在演变。该诊断基于临床症状,并通过组织学和培养结果得以确立。计算机断层扫描在PML的诊断和病情监测中似乎具有重要价值。