成人单纯疱疹病毒性脑炎CT脑实质、脑室及蛛网膜下腔结构改变与颅内压的关系

Relationship between Intracrania Pressure and the Change of Intracerebral Brain Parenchyma and Cavitas Subarachnoidealis or Ventricle in CT of Herpes Simplex Encephalitis in Adult

目的:探讨成人单纯疱疹病毒性脑炎CT脑实质、脑室及蛛网膜下腔(脑腔室)结构改变与颅内压的关系及指导临床脱水的价值。方法:对19例单纯疱疹病毒性脑炎患者CT资料以及腰穿测得的颅内压进行回顾性分析。结果:(1)CT显示脑实质异常6例(32%),其中双侧颞叶对称性低密度病变5例,单侧颞叶1例,额叶3例,其它脑实质结构3例。CT显示脑室蛛网膜下腔结构异常12例(63%)。(2)腰穿压力增高15例中CT显示脑实质双侧颞叶异常5例(26%),脑室或蛛网膜下腔改变12例(62%)。结论:CT发现单纯疱疹病毒性脑炎患者的双侧脑实质或脑腔室改变征象均提示颅内压升高,应给予脱水治疗。

Objective： To explore the relationship between intraerania pressure and the change of Intracerebral Brain Parenehyma and cavitas subaraehnoidealis or ventricle in CT image of herpes simplex encephalitis in adult. Methods： Intracrania pressure and CT findings of 19 adult patients with herpes simplex encephalitis were analyzed retrospectively.Results： （1） 6 cases （32%） were seen abnormal signs from brain parenchyma, included hypodensity lesions in bilateral temporal lobes （n=5）, lateral tempora （n=l）, frontallobes （n=3） and other part of brain parenchyma（n=3）, abnormal signs from cavitas subarachnoidealis or ventricle （n=12）. （2） 5 cases （26%） and 12 cases （62%）of high intracranial pressure were seen abnormal signs in bilateral temporal lobes and cavitas subarachnoidealis or ventricle. Conclusion： CT images show the change of intracerebral brain parenchyma and cavitas subarachnoidealis or ventricle of herpes simplex encephalitis in adult, the dehydration treatment should be given to the patients.