Neurology:抗炎治疗下颅内动脉瘤壁强化减弱

2018-11-22 zyx整理 神经科病例撷英拾粹

68岁女性,表现为视野缺损,由巨大的颈动脉-眼动脉瘤压迫右侧视神经所致。 开始给予类固醇激素1mg/kg/d,3月后剂量减少,症状缓解。

68岁女性,表现为视野缺损,由巨大的颈动脉-眼动脉瘤压迫右侧视神经所致。 开始给予类固醇激素1mg/kg/d,3月后剂量减少,症状缓解。患者拒绝其他任何治疗手段。血管壁MRI(图)可见6周时初始圆周形动脉瘤壁强化(CAWE)强度和厚度降低,持续1年。CAWE被认为可能与炎症有关,是动脉瘤不稳定的标志。该观察结果提示类固醇激素对动脉瘤壁强化的抗炎作用可能有助于视神经麻痹的好转。


(图:A-C:横断面可见右侧颈内动脉瘤[F]厚的圆周形动脉壁强化在类固醇激素治疗下呈现持续的强化减弱;D-E:冠状位可见视神经和视交叉受压[箭头])

原始出处:Edjlali M, Boulouis G, Derraz I, et al. Intracranial aneurysm wall enhancement decreases under anti-inflammatory treatment. Neurology. 2018 Oct 23;91(17):804-805. 

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