Chang W N, Lui C C, Chang J M
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1996 Mar;57(3):191-7.
To evaluate the brain lesions of eight eclamptic patients with computed tomogram (CT) and magnetic resonance imaging (MRI) and correlate their radiologic lesions with the neurologic symptoms.
We recorded and followed up the neurologic presentations of eight eclamptic patients. They received brain CT and MRI the first two days after the development of seizures, then follow-up study of the brain lesions with MRI. Correlation of their radiologic brain lesions with neurologic presentations was also done.
Radiologic studies of these patients showed hypoxic-ischemic brain lesions and brain edema involving the temporo-parieto-occipital junctions; these lesions were bilateral and relatively symmetrical in distribution. Other involved regions of the brain included the basal ganglia, periventricular white matter, internal and external capsules and scattered lesions involving various lobes. Almost all the radiologic brain lesions had had total resolution in the follow-up MRI study. Besides generalized tonic-clonic seizure, the other neurologic presentations included headache, blurred vision, and dizziness.
Although the brain lesions involved many regions, the temporo-parieto-occipital junction is the most frequently involved area. The incidence of appearance of brain lesions in radiologic study is greatly affected by the temporal relationship of the scan to the development of seizure. Visual disturbance and headache have a good correlation with radiologic findings, i.e. occipital lobe involvement and diffuse brain edema, respectively. However, some of the other neurologic presentations do not have comparable radiologic lesions.
采用计算机断层扫描(CT)和磁共振成像(MRI)评估8例子痫患者的脑部病变,并将其影像学病变与神经症状相关联。
记录并随访8例子痫患者的神经症状表现。在癫痫发作后的头两天,患者接受脑部CT和MRI检查,随后用MRI对脑部病变进行随访研究。还对其脑部影像学病变与神经症状表现进行了相关性分析。
这些患者的影像学研究显示,存在缺氧缺血性脑损伤和累及颞顶枕交界区的脑水肿;这些病变为双侧性,分布相对对称。脑部的其他受累区域包括基底神经节、脑室周围白质、内囊和外囊,以及累及各个脑叶的散在病变。在随访的MRI研究中,几乎所有的脑部影像学病变都已完全消退。除全身性强直阵挛发作外,其他神经症状表现包括头痛、视力模糊和头晕。
虽然脑部病变累及多个区域,但颞顶枕交界区是最常受累的区域。影像学研究中脑部病变出现的发生率受扫描与癫痫发作时间关系的影响很大。视觉障碍和头痛分别与影像学表现(即枕叶受累和弥漫性脑水肿)有很好的相关性。然而,其他一些神经症状表现并无相应的影像学病变。