摘要
目的分析水痘-带状疱疹病毒(VZV)引起的脑动脉炎的临床特征、影像学和病理改变。方法对2例VZV脑动脉炎患者的临床表现、辅助检查、影像学和病理特征进行了总结。结果患者为急性起病,表现为脑卒中样发作,从病毒感染到脑梗死的发生间隔时间分别为5d和6个月,头颅MRI表现为半卵圆、双侧基底节区的多发性长T1、长T2信号,注射钆喷酸葡胺(Gd-DTPA)后无增强效应。数字减影血管造影术(DSA)检查发现在大脑中动脉、前动脉存在多处狭窄段。病理学检查发现,在脑组织血管周围有炎性细胞浸润,呈血管鞘样,脑内血管存在多处明显的纤维素样坏死。该病预后良好。结论VZV引起的脑动脉炎存在病毒前驱感染病史,具有较为特征的临床和影像学表现。
Objective To analyze the clinical features, neurolmage and pathologic changes in varicella-zoster virus-induced vasculitis presenting with cerebral infarction. Methods The clinical data including clinical manifestation, laboratory examination, neuroimage and pathologic changes of the two patients with varicella- zoster virus-induced vasculitis presenting with cerebral infarction were collected and analyzed. Results The patients presented acute ischemie-stroke episode attacks. The latent period between the viral infection and neurological complaints was 5 days and 6 months respectively, MRI image showed abnormal signals in the territory of the bilateral anterior and middle cerebral artery, indicated the presence of acute multi-focal infarction, and digital subtraction angiography (DSA) showed multiple scattered segments of irregularity and narrowing involving the small and medium-sized vessels. Neuropathologic study demonstrated fibrinoid necrosis and infiltration of inflammation cells around vessel wall. Conclusions Varicella-zoster virus-induced cerebral vasculitis has a prodrome of viral infection, and possesses characteristic clinical features.
出处
《中国神经免疫学和神经病学杂志》
CAS
2007年第2期105-108,共4页
Chinese Journal of Neuroimmunology and Neurology
关键词
水痘-带状疱疹
脑动脉炎
脑梗死
varicella zoster virus
cerebral vasculitis
cerebral infarction