可逆性胼胝体压部病变综合征5例

Reversible splenial lesion syndrome in 5 patients

目的探讨可逆性胼胝体压部病变综合征的临床特点和MR表现。方法回顾性分析2013年1月—2014年12月首都医科大学宣武医院神经内科收治的可逆性胼胝体压部病变综合征5例患者的临床及影像学资料。结果 5例患者中男3例,女2例。发热4例,腹泻2例,精神行为异常4例,癫痫2例。5例均行腰穿检查,除1例患者CSF白细胞1 340×10~6/L,其余4例CSF常规和生化均正常。5例患者分别于发病后3~11 d行头颅MR检察,均显示为胼胝体压部异常信号,T1WI低或稍低信号,T2WI高或稍高信号。DWI为高信号,增强扫描均无强化。3例给予阿昔洛韦治疗,1例给予罗氏芬和甘露醇治疗,1例给予甲泼尼龙治疗。全部患者在发病后11~26 d复查MR显示病灶消失,发病20~33 d后临床症状完全缓解。结论可逆性胼胝体压部病变综合征可见于多种疾病,临床症状轻微,影像学改变可逆,预后良好。

Objective To investigate the clinical features anti MR features of the reversible corpus callosum lesion syndrome. Methods From January 2013 to December 2014, retrospective analysis the clinical and imaging data of 5 cases of the reversibility of the corpus callosum splenium lesion syndrome from Capital Medical University Xuanwu Hospital, Depart- ment of Neurology. Results In the 5 patients, male of 3 cases, female of 2 cases. Fever oeeurred in 4 cases, diarrhea in 2 cases, abnormal mental behavior in 4 eases, and epilepsy in 2 cases. All 5 cases underwent lumbar puncture expect 1 patient, CSF WBC 1 340 × 106/L, the remaining 4 eases were normal routine and biochemical CSF. 5 patients were underwent head MR 3 - II days after the onset, all were displayed as the corpus callosum pressure abnormal signal, T1WI showed low or slightly low signal, T2WI showed high or slightly high signal. DWI was high signal, amt the enhanced scan revealed no en- hancement. 3 patients were treated with acyclovir treatment, 1 cases were treated with Ceftriaxone amt mannitol, 1 cases trea- ted with methylprednisolone. The symptoms disappeared from l I to 26 d after the onset of the disease, and the clinical symp- toms were completely relieved after 20 to 33 days. Conclusion Reversible corpus callosum body pressure lesion syndrome can be found in a variety of diseases, with mild clinical symptoms, radiographic changes reversible, the prognosis is good.