维生素B12缺乏引起小脑病变1例及机制探讨

目的 观察1例维生素B12缺乏引起小脑病变患者的临床表现、影像学特点,探讨其发病机制.方法 收集该患者的病史及住院治疗期间体格检查、影像学检查和实验室检测资料.结果 患者维生素B12严重缺乏、巨幼红细胞性贫血.头颅核磁共振检查提示双侧小脑半球对称性大片状长T1、长T2信号,双侧放射冠、双侧基底节及脑桥腔梗灶.予大剂量维生素Bn治疗3周后复查头颅核磁共振示小脑病变基本消失.结论 维生素B12缺乏可引起小脑病变,感染可能为诱因;小脑双侧对称性病变应考虑有无维生素B12缺乏可能.

Mechanism of cerebellum changes in a vitamin B12 deficiency patient

Objective To observe clinical features and brain magnetic resonance imaging （MRI） of a pa tient with deficiency of vitamin B12 and to discuss the mechanism of cerebellum changes.Methods Collecting clinical data of the patient including medical history,physical examination,imaging examination and laboratory tests.Results This patient was found to be with macrocytic anemia,and low serum vitamin B12 level.Brain MRI showed hyperintense signal changes in bilateral cerebellar hemispheres on T2 weighted images.Three weeks after initiation of vitamin B12,MRI revealed complete resolution of abnormal cerebellar signals.Conclusions Deficiency of vitamin B12 may cause cerebellum disease.Deficiency of vitamin B12 should be thought of when abnormal signal changes in bilateral cerebellar hemispheres found.Infection may be precipitating factor.