Neurology:可逆性巨大蛛网膜颗粒

2019-01-31 zyx整理 神经科病例撷英拾粹

16岁反复短暂性视力丧失男孩,可见双侧视乳头水肿。

16岁反复短暂性视力丧失男孩,可见双侧视乳头水肿。MRI提示双侧横窦可见巨大的蛛网膜颗粒(GAG)和颅内高压征象(图)。脑脊液开放压力为420mm H2O。腰椎穿刺放完脑脊液后,GAG体积减少,窦腔狭窄缓解(图)。蛛网膜颗粒(AG)是脑脊液通过硬脑膜缺损疝入静脉窦。GAG可能是颅内高压的结果,因放液后GAG消退。本例支持Krisch理论,其认为AG是脑脊液的缓冲区而不是脑脊液吸收部位。

(图:T2WI可见视神经扭曲[箭头,A];T1增强[B,C]和磁共振静脉成像[D]提示巨大的蛛网膜颗粒[GAG,*]和窦腔狭窄[箭头,B];腰椎穿刺后5天,视神经扭曲[箭头,E],GAG[箭,F-H]和窦腔狭窄[箭头,F]好转)

原始出处:Taieb G, Dargazanli C, Prin P, et al. Reversible giant arachnoid granulations. Neurology. 2018 Dec 11;

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    2019-08-17 yinhl1978
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    2019-04-09 aliceclz
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