Neurology:见于呼吸衰竭相关危重病的特殊脑微出血模式

2018-06-22 zyx整理 神经科病例撷英拾粹

51岁痴呆男性,表现为意识状态改变,最初的头颅CT和MRI无明显异常。住院期间出现了较多并发症,包括吸入性肺炎,缺氧和急性呼吸窘迫综合征,需要插管。

51岁痴呆男性,表现为意识状态改变,最初的头颅CT和MRI无明显异常。住院期间出现了较多并发症,包括吸入性肺炎,缺氧和急性呼吸窘迫综合征,需要插管。抗生素治疗后正在改善,但1周后出现癫痫发作。MRI可见累及皮质下白质,内囊和胼胝体多发新微出血灶,深部白质和深部灰质不受累(图)。这一特殊模式见于罹患1型呼吸衰竭的危重患者,与身处高海拔地区类似。将其与其他微出血病因(包括高血压,弥漫性轴索损伤和脑淀粉样血管病)区分开来十分重要。


(图:A-C:SWI可见累及皮质下白质,胼胝体和内囊的广泛点状微出血)

原始出处:

Hall JP, Minhas P, Kontzialis M, Jhaveri MD. Teaching NeuroImages: Distinct brain microhemorrhage pattern in critical illness associated withrespiratory failure.Neurology. 2018 May 29;90(22):e2011.

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    2018-09-05 yinhl1978
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  5. [GetPortalCommentsPageByObjectIdResponse(id=2000474, encodeId=249e20004e4fa, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Sep 05 07:17:00 CST 2018, time=2018-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1674857, encodeId=2a1616e485717, content=<a href='/topic/show?id=60fb50501b3' target=_blank style='color:#2F92EE;'>#微出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50501, encryptionId=60fb50501b3, topicName=微出血)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5c7927121733, createdName=liuxiaona, createdTime=Sun Feb 24 20:17:00 CST 2019, time=2019-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1690461, encodeId=08d116904610c, content=<a href='/topic/show?id=fdb336e49bb' target=_blank style='color:#2F92EE;'>#危重病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36749, encryptionId=fdb336e49bb, topicName=危重病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=27f729051889, createdName=xinmeili, createdTime=Wed May 08 10:17:00 CST 2019, time=2019-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393550, encodeId=92ee139355098, content=<a href='/topic/show?id=7ee28485472' target=_blank style='color:#2F92EE;'>#脑微出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84854, encryptionId=7ee28485472, topicName=脑微出血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d0b2500136, createdName=12498b08m90暂无昵称, createdTime=Sat Jun 23 16:17:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326259, encodeId=48ab3262596f, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sat Jun 23 05:54:58 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326116, encodeId=c296326116af, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Fri Jun 22 14:38:19 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326029, encodeId=06bb32602902, content=学习学习.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Fri Jun 22 06:44:26 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326016, encodeId=88ea326016c5, content=学习学习再学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Fri Jun 22 05:37:39 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326012, encodeId=55833260123a, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Fri Jun 22 05:27:01 CST 2018, time=2018-06-22, status=1, ipAttribution=)]
    2018-06-23 lofter

    学习了感谢分享

    0

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    2018-06-22 一个字-牛

    学习了谢谢分享

    0

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    2018-06-22 1dd8c52fm63(暂无匿称)

    学习学习.继续关注

    0

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    2018-06-22 yjs木玉

    学习学习再学习

    0

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    2018-06-22 深海的鱼

    学习学习学习

    0

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