一例特发性颅内高压并发幕下和幕上皮质浅层蛛网膜病:为病理生理学提供线索的体细胞内不相干运动磁共振成像新发现。

IF 3.2 Q2 CLINICAL NEUROLOGY
Shinya Watanabe, Yasushi Shibata, Eiichi Ishikawa
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引用次数: 0

摘要

特发性颅内高压症(IIH)是一种以乳头水肿和颅内压增高(ICP)为特征的疾病,其病理机制尚不清楚;这种疾病的症状包括视力下降、头痛和搏动性耳鸣,严重影响患者的生活质量。相比之下,血色素沉积症(SS)是一种血色素沉积在大脑皮层和小脑表面的疾病,有可能导致小脑共济失调或听力损失。迄今为止,尚无 IIH 伴有幕下和幕上皮质 SS 的病例报道。在此,我们报告了一例 31 岁女性肥胖患者的病例。患者突然出现头痛和头晕,行走困难,随后意识到复视。眼底检查发现双侧视神经充血乳头和右眼外展障碍。头部磁共振成像(MRI)显示小脑表面和大脑皮层有突出的 SS。腰椎穿刺显示 IICP 为 32 cmH2O,符合 IIH 诊断标准,并开始口服乙酰唑胺治疗;随后,颅内压降至 20 cmH2O。她的外展障碍消失了,视乳头肿胀也有所改善。现在,她已经能够恢复教师生活,没有留下任何后遗症。SS 是蛛网膜下腔持续性轻微出血所致。在本病例中,同时观察到了蛛网膜下腔和蛛网膜上腔皮质浅层 SS。虽然 IIH 并发 SS 的病例很少见,但我们应该牢记,从我们的病例中可以推断出 IIH 和 SS 之间存在因果关系。我们的研究结果还表明,利用核磁共振成像进行脑脊液动态分析可有效诊断 IIH 并确定治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Case of Idiopathic Intracranial Hypertension Complicated with both Infratentorial and Supratentorial Cortical Superficial Siderosis: Novel Imaging Findings on Intravoxel Incoherent Motion Magnetic Resonance Imaging Offering Clues to Pathophysiology.

The pathology of idiopathic intracranial hypertension (IIH), a disease characterized by papillary edema and increased intracranial pressure (IICP), is not yet understood; this disease significantly affects quality of life due to symptoms including vision loss, headache, and pulsatile tinnitus. By contrast, superficial siderosis (SS), a disorder in which hemosiderin is deposited on the surface of the cerebral cortex and cerebellum, potentially causes cerebellar ataxia or hearing loss. So far, no cases of IIH with infratentorial and supratentorial cortical SS have been reported. Herein, we report a case of a 31-year-old woman with obesity who developed this condition. The patient suddenly developed headache and dizziness, had difficulty walking, and subsequently became aware of diplopia. Fundus examination revealed bilateral optic nerve congestive papillae and right eye abducens disturbance. Head magnetic resonance imaging (MRI) showed prominent SS on the cerebellar surface and cerebral cortex. Lumbar puncture revealed IICP of 32 cmH2O, consistent with the diagnostic criteria for IIH, and treatment with oral acetazolamide was started; subsequently, the intracranial pressure decreased to 20 cmH2O. Her abduction disorder disappeared, and the swelling of the optic papilla improved. She was now able return to her life as a teacher without any sequelae. SS is caused by persistent slight hemorrhage into the subarachnoid space. In this case, both infratentorial and supratentorial cortical superficial SS was observed. Although cases of IIH complicated by SS are rare, it should be kept in mind that a causal relationship between IIH and SS was inferred from our case. Our findings also suggest that cerebrospinal fluid dynamic analysis using MRI is effective in diagnosing IIH and in determining the efficacy of treatment.

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来源期刊
Neurology International
Neurology International CLINICAL NEUROLOGY-
CiteScore
3.70
自引率
3.30%
发文量
69
审稿时长
11 weeks
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