由于COVID-19而导致的急性出血性白细胞脑炎的恢复
Nicholas Bunting1, Robert Martynoga2, Henry Crayton3
1Coffs Harbour Base Hospital, Coffs Harbour, New South Wales, Australia nick.bunting01@gmail.com.
BMJ case reports
|August 9, 2024
概括
在COVID-19感染后出现的神经症状的急性出血性白细胞脑炎 (AHLE) 的罕见病例. 及时诊断和治疗,包括血交换,导致了患者的良好康复.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 神经免疫学 神经免疫学
背景情况:
- COVID-19 感染可以引发罕见的神经复杂症.
- 急性扩散性脑膜炎 (ADEM) 是急性神经系统缺陷的潜在诊断.
- 急性出血性白细胞脑炎 (AHLE) 是一种严重的,快速进展的脱髓化疾病.
研究的目的:
- 报告COVID-19的第二次AHLE病例.
- 突出 AHLE 的诊断挑战和治疗策略.
- 强调在COVID-19后出现严重神经症状的患者考虑AHLE的重要性.
主要方法:
- 一个中年男性的临床表现,表达性失言症和面部垂垂.
- 神经成像 (MRI) 显示了双边半球质量效应和.
- 脑脊液分析显示中性粒细胞占主导地位和蛋白质的增加.
- 大脑活检证实了脱髓化过程.
- 用高剂量的甲基前醇和血交换进行治疗.
主要成果:
- 患者出现了模仿ADEM的症状.
- 确诊了COVID-19感染的情况.
- 大脑活检证实了AHLE.
- 患者在血交换和支持性护理后表现出极好的康复.
结论:
- AHLE是一种罕见但严重的COVID-19的神经并发症.
- 早期诊断和积极的治疗,包括血交换,可以带来有利的结果.
- 临床医生应在COVID-19患者急性神经系统恶化的差异诊断中考虑AHLE.
更多相关视频
09:14Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
2.3K
08:36Author Spotlight: Evaluating the Adjuvant Efficacy and Safety of Angong Niuhuang Pill in Viral Encephalitis Treatment
Published on: April 19, 2024
467
相关概念视频
Arboviral Encephalitis
Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
Hepatic Encephalopathy
DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...
