可逆性后部脑病综合征的病因、临床及影像学特点

目的 了解可逆性后部脑病综合征的临床及影像学特点,探讨其病因及可能的发病机制.方法 回顾性分析13例可逆性后部脑病综合征患者的基础病、临床表现、影像特点,随访了解预后.结果 与可逆性后部脑病综合征相关的常见疾病有各种肾病肾功能不全、妊娠及产后子痫、结缔组织病、免疫抑制剂应用等.临床表现主要为头痛、抽搐、视力下降、精神意识改变等.影像学具有多灶性、对称性、后部为主分布的特点,累及枕、顶、额的皮质及皮质下白质病灶.一般预后较好,少数较差.结论 可逆性后部脑病综合征的病因机制并不相同,病变并不都可逆,寻找病因、治疗原发病对预后有决定性意义.

Etiological,clinical and imaging characters of reversible posterior encephalopathy syndrome

Objective To elucidate the clinical and imaging chalaeters of reversible posterior encephalopathy syndrome(PRES)and to discuss the etiological factors and the pwbable pathogenesis.Method Retrospective analysis of basal diseases,clinical manifestations and imaging characters of 13 PRES patients was conducted with follow-ups.Results The comlmon associated diseases are various kinds of kidney disease and renal inadequacy,eclampsia of gravidity and postpartum,connective tissue disease and immunosuppressives,et al.The main clinical manifestations are headache,convulsion,poor vision,changes of psychology or consciousness.The radiological findings are multifocal,symmetrical and posteriorly dismbuted in the cerebral hemispheres involving bilateral grey and white matter abnormalities in occipital,parietal and frontal regions.The majority of patients with PRES have all excellent prognosis.Conclusion The etiological factors and pathogenesis of PRES ale different and not all of them are reversible.Thus it is decisive to take Bpecific and appropriate measures.