一种后部可逆脑病综合征的病例,使胸椎脊柱皮血瘤复杂化
Tamotsu Gotou1,2, Yuto Munemura1, Takahiro Hagihara1
1Department of Emergency and Critical Care Medicine, Tottori Prefectural Central Hospital, Tottori, JPN.
Cureus
|February 17, 2026
概括
后回性脑病综合征 (PRES) 很少会与脊髓血瘤一起发生. 在这种罕见的临床场景中,迅速控制血压和脑部MRI对于诊断和管理PRES至关重要.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 临界护理医学 临界护理医学
背景情况:
- 后回性脑病综合征 (PRES) 是一种临床放射性疾病,其特征是神经症状和特征性脑成像发现.
- 虽然已知PRES的常见沉物,但其与脊髓血瘤的关联是非常罕见的.
研究的目的:
- 报告一个罕见的PRES复杂性脊髓血瘤病例.
- 突出潜在的触发因素,并强调及时诊断和管理的重要性.
主要方法:
- 一份病例报告显示,一名68岁的男性出现背痛,高血压和神经症状.
- 诊断工作包括胸脊MRI和脑MRI.
- 管理包括重症监护病房监测,持续的抗高血压输液和镇痛/镇静.
主要成果:
- 患者在背部疼痛开始后出现严重的高血压,,头痛和视觉障碍.
- 胸部脊柱MRI显示脊柱下硬质血瘤,脑部MRI证实了PRES.
- 神经症状通过血压控制和支持性护理得到缓解.
结论:
- 脊柱血瘤的不常见但可能的并发症是PRES.
- 潜在的触发因素包括与疼痛相关的高血压,自主功能障碍和液体失衡.
- 在怀疑脊柱血瘤患者患有PRES时,迅速识别,血压管理和脑部成像是至关重要的.
相关概念视频
Hemorrhagic Stroke l: Introduction
20
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...
20
Hemorrhagic Stroke ll: Pathophysiology
30
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...
30
Encephalitis l: Introduction
15
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...
15
Brain Abscess l: Introduction
21
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial...
21
Cerebral Edema ll: Pathophysiology
19
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this...
19
Hepatic Encephalopathy
53
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...
53


