AJNR:动脉栓塞术后迟发白质病变的原因

2020-04-04 杨中华 脑血管病及重症文献导读

下面报道了一例左侧 ICA 动脉瘤栓塞术后延迟白质脑病患者。

延迟白质脑病是动脉瘤血管内弹簧圈栓塞术的并发症,有几个名字,包括延迟白质脑病、延迟强化损害和延迟多发白质损害等。名字的差异提示病因学的不同,包括手术过程中使用的亲水涂层异物的肉芽反应,造影剂诱导脑病,以及镍或具有生物活性的聚甘醇酸/聚乳酸弹簧圈过敏。

下面报道了一例左侧 ICA 动脉瘤栓塞术后延迟白质脑病患者。A 图,可见动脉瘤最大直径>17mm;B 图,双微导管技术血管内弹簧圈栓塞术后;C 图,55天后发现右侧无力,Flair 显示左侧颞枕叶区域大片高信号改变;D 图,相同区域可见散在强化;E 图,SWI 可见点状低信号。患者住院,并给予激素冲击治疗,症状和影像学改善:

原始出处:A. Ikemura, T. Ishibashi, K. Otani, et al. Delayed Leukoencephalopathy: A Rare Complication after Coiling of Cerebral Aneurysms. AJNR Am J Neuroradiol. 2020 Feb;

 

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