非典型的后部可逆脑病症综合征:在移植后的一种晶状叉标志
Franco E Appiani1,2,3, Carlos S Claverie4,5, Francisco R Klein4,5,6
1Universitat Internacional de Catalunya Barcelona Spain.
Clinical case reports
|August 2, 2024
概括
后部可逆脑病综合征 (PRES) 可以在基底中呈现非典型的"形叉标志",而不仅仅是在典型的尾部区域. 识别这个标志有助于在移植受体中诊断PRES,即使没有功能衰竭.
科学领域:
- 神经科学是一个神经科学.
- 放射学 放射学是一门学科.
- 移植医学 移植医学 移植医学
背景情况:
- 后部可逆脑病综合征 (PRES) 是一种神经疾病,在移植受体中经常与免疫抑制药物 (ISD) 相关.
- 典型的PRES呈现的是围白质中的血管性,但存在非典型的呈现.
- "形叉标志"的特征是基底腺胀,通常与尿路性脑病变有关.
研究的目的:
- 在肺和肝移植接受者中报告一种具有"形叉标志"的非传统PRES病例.
- 突出非典型的PRES成像发现的诊断意义,特别是"形叉标志".
- 强调识别各种PRES表现的重要性,以便及时和准确地管理患者.
主要方法:
- 一个19岁的男性移植接受者的病例报告,在手术后经历了发作.
- 磁共振成像 (MRI) 用于评估神经症状和识别脑的模式.
- 临床管理包括调整ISD和服用补充剂.
主要成果:
- 核磁共振扫描显示了一种非典型的PRES模式,在基底质中带有双边对称的血管性,显示"形叉标志".
- 患者缺乏典型的新陈代谢障碍,如功能衰竭,挑战了这种症状的通常关联.
- 针对性管理干预后的14天内实现了临床和神经成像解析.
结论:
- "形叉标志"可以在尿性脑病症之外的PRES中表现出来,这可能表明深白质中的血脑屏障被破坏.
- 这一案例强调了PRES的可变性和神经成像在诊断移植患者复杂表现中的关键作用.
- 早期识别非典型的PRES成像发现,如"形叉标志",对于有效的管理和改善患者的治疗结果至关重要.
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