Okino S, Sakajiri K I, Fukushima K, Ide Y, Takamori M
Department of Neurology, School of Medicine, Kanazawa University.
Rinsho Shinkeigaku. 1993 May;33(5):530-4.
A 63-year-old woman with Wernicke-Korsakoff syndrome, despite the absence of alcoholism and malnutrition, is reported. She had undergone gastrojejunostomy for ileus 30 years ago, and this operation was thought to be an important risk factor for her vitamin B1 deficiency. Brain MRI showed symmetrical high intensity areas on T2-weighted images in the periaqueductal region and bilateral dorsomedial nuclei of the thalamus. On single photon emission computed tomography (SPECT) using 99mTc-hexamethylpropyleneamine oxime, bilateral frontal perfusion was reduced, which was attributed to thalamo-cortical diaschisis due to injury to the dorsomedial nuclei of the thalamus. Presumably this phenomenon explains the Korsakoff psychosis. A history of gastrojejunostomy, even if normal intake is possible, is a risk factor for vitamin B1 deficiency, and should be considered in the differential diagnosis of Wernicke-Korsakoff syndrome.
据报道，有一名63岁的女性患有韦尼克-科尔萨科夫综合征，尽管她没有酗酒和营养不良的情况。她30年前因肠梗阻接受了胃空肠吻合术，该手术被认为是她维生素B1缺乏的重要危险因素。脑部磁共振成像（MRI）显示，在导水管周围区域和丘脑双侧背内侧核的T2加权图像上有对称的高强度区域。在使用99mTc-六甲基丙烯胺肟的单光子发射计算机断层扫描（SPECT）中，双侧额叶灌注减少，这归因于丘脑背内侧核损伤导致的丘脑-皮质远隔性机能障碍。据推测，这种现象解释了科尔萨科夫精神病。胃空肠吻合术史，即使可能正常摄入，也是维生素B1缺乏的危险因素，在韦尼克-科尔萨科夫综合征的鉴别诊断中应予以考虑。
