Neurology:Sneddon综合征1例

2019-10-24 zyx整理 神经科病例撷英拾粹

34岁女性,表现为急性起病的左侧面部无力和构音障碍。

34岁女性,表现为急性起病的左侧面部无力和构音障碍。查体可见弥漫的葡萄状青斑(livedo racemosa)(图A)。脑MRI证实右侧额叶急性卒中(图B),深部白质多发慢性缺血性病变(图C)。CT血管造影可见沿颅内血管皮质支多发不规则走形(图D和E)。皮肤活检无殊。全面的免疫学,血液学和感染筛查未见明显异常。患者被诊断为Sneddon综合征,带口服阿司匹林出院。

Sneddon综合征是一种非炎症性动脉病,具有典型的神经血管和皮肤征象。通常与抗磷脂综合征或自身免疫性疾病相关,其病理生理学仍不明确。


(图:A:皮肤检查可见腿部网状紫罗兰色-红斑,符合葡萄状青斑;B:脑MRI可见右额侧叶弥散受限病灶,符合急性缺血性中风;C:FLAIR可见大脑半球深部白质和皮质-皮质下区域多发慢性缺血性病变[箭];D-E:脑CT血管造影可见左右大脑中动脉皮质支多发不规则走形,主要位于M2和M3段[箭];沿右侧大脑后动脉有类似表现[未放图])

原始出处:

Almutlaq A, Alshurem M, Levesque-Roy M, Massie R. Teaching NeuroImages: Sneddon syndrome. Neurology. 2019 Sep 17;93(12):e1227-e1228.

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