摘要
目的探讨子痫前期或子痫致可逆性后部脑病综合征（posterior reversible encephalopathy syndrome，PRES）的临床及影像学特点。方法选择子痫前期或子痫致PRES患者21例，采用回顾性分析方法对临床症状及脑磁共振成像（magnetic resonance imaging，MRI）资料进行分析。结果主要临床症状：21例患者中癫痫发作18例，头痛16例，意识状态改变15例，视觉障碍12例；PRES病灶分布：顶、枕叶20例，额叶14例，颞叶11例，基底节区11例，胼胝体压部4例，小脑半球3例，脑干1例；PRES病灶分布模式：经典型7例，全脑型7例，额上沟型6例，部分或不对称型1例。结论子痫前期或子痫致PRES临床症状典型，除顶、枕叶外，额叶、颞叶、基底节区等部位累及常见，多见3种主要病灶分布模式，准确识别其影像学表现对正确诊断具有重要意义。
Objective To investigate the clinical and radiologic features of posterior reversible encephalopathy syndrome （PRES） associated with preeclampsia-eclampsia. Methods Twenty-one cases of PRES associated with preeclampsia-eclampsia were retrospectively studied on some aspects of clinical and radiologic features. Results The most common clinical presentations were seizures （18 cases）, headache （16 cases）, altered mentation （15 cases） and vision change （12 cases）. Vasogenic edema lesions distributed in the parietal or occipital lobe （20 cases ）, the frontal lobes （ 14 cases）, temporal lobes （ 11 cases）, and basal ganglia （11 cases）. The splenium involvement occurred in 4 cases, cerebellar hemispheres and brain stem involvement was presented in 3 cases and 1 case separately. Three major patterns of PRES included dominant parietal-occipital （7 cases） ,the holohemispheric watershed （7 cases） , and superior frontal sulcal （6 cases）. Partial and asymmetric expression of PRES only occurred in l case. Conclusions The clinical features of PRES associated with preeclampsia-eelampsia are typical. Except the parietal or occipital lobe, involvement of the frontal lobe, temporal lobe and basal ganglia is common, followed by the occasional presence of the splenium, cerebellar hemispheres and brain stem. Three primary PRES patterns are noted, occasional with partial and asymmetric expression of PRES. Awareness of these typical and variable characteristics is important to recognize the PRES neurotoxicity more accurately when PRES present.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2012年第4期254-258,共5页
Chinese Journal of Neurology
关键词
先兆子痫
子痫
后部白质脑病综合征
脑水肿
磁共振成像
Pre-eclampsia
Eclampsia
Posterior leukoencephalopathy syndrome
Brainedema
Magnetic resonance imaging
