可逆性胼胝体压部病变综合征临床分析

Clinical analysis of reversible corpus callosum lesion syndrome

目的探讨可逆性胼胝体压部病变综合征(reversible splenial lesion syndrome,RESLES)的病因、临床表现、影像学特征、治疗及预后。方法回顾4例确诊为RESLES患者的临床资料,结合相关文献进行分析。结果 4例患者中男1例,女3例,呈急性病程,病因均为感染,临床表现各异,4例患者均行腰穿检查,除1例患者脑脊液(cerebrospinal fluid,CSF)白细胞12×10~6个/L,其余3例CSF相关检测均正常。头颅MRI表现为胼胝体压部(splenium of corpus callosum,SCC)的类圆形或条索状病灶,其中2例同时累及双侧脑白质,病灶呈T_1等或稍长信号、T_2稍长信号,DWI高信号,增强扫描后病灶无强化。临床表现多样且无特异性,针对原发病及对症治疗后头颅MRI病灶消失,预后较好。结论本组4例患者的临床症状及颅内病灶分布罕见,对进一步探讨RESLES的诊断及治疗提供相关的参考依据。

Objective To investigate the etiology,clinical manifestations,imaging features,treatment and prognosis of reversible splenial lesion syndrome(RESLES).Methods The clinical data of 4 patients diagnosed as RESLES were reviewed and analyzed with relevant literature.Results All 4 patients underwent lumbar puncture to check cerebrospinal fluid.In one case,his white blood cell count was 12×10^6/L,the results of other patients were normal.The head MRI is a round or cord-like lesion of the splenium of corpus callosum(SCC).Two of them involve bilateral white matter at the same time.The lesion is T 1 or slightly longer signal,T 2 slightly longer signal,DWI high signal,enhanced lesions without enhancement after scanning.The clinical manifestations were diverse and non specific.The MRI lesions of the head after the primary disease and symptomatic treatment disappeared,and the prognosis was good.The head MRI showed round or cord like lesions in the splenium of corpus callosum,and two of which involved bilateral white matter.The lesion demonstrated equal or long T 1 signal,long T 2 signal and high DWI signal,but no enhancement after enhanced scanning.The clinical manifestations were diverse and non specific.Head MRI examination showed the head lesions disappeared after treatment for primary disease and symptoms,for which the patients have a good prognosis.Conclusion The clinical symptoms and intracranial lesions of the 4 patients are rare,which provides a reference for the diagnosis and treatment of RESLES.