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Neurology：斜坡梗死后出现的颅神经麻痹病例

2019-10-24 zyx 神经科病例撷英拾粹

斜坡梗死颅神经麻痹水肿
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18岁罹患血红蛋白SS型镰状细胞病男性,表现为急性头痛和水平复视。查体发现右侧第六颅神经（外展神经）麻痹。

18岁罹患血红蛋白SS型镰状细胞病男性,表现为急性头痛和水平复视。查体发现右侧第六颅神经（外展神经）麻痹。第2天患者出现同侧第七颅神经（面神经）麻痹。神经影像学符合斜坡骨性梗死,考虑继发于镰状细胞病和邻近硬脑膜炎症（图）。患者临床症状和影像学表现提示第六和第七颅神经短暂性炎症反应,因其沿着颅底走行于梗死周围炎症附近。患者因镰状血红蛋白水平升高接受血液净化（血液成分单采）,1周后症状消失。复查影像学可见炎症区域消散以及骨性梗死演变。2年时随访评估无殊,症状未复发。


（图：FLAIR可见整个斜坡不同程度水肿[A-B,箭],斜坡后硬脑膜突出,不对称增厚[C,箭]；T1增强可见骨[C,黑箭]和硬脑膜[C,白箭]内不均匀强化）

原始出处：Wong J, Gambrah-Sampaney C, Adang L. Teaching NeuroImages： Cranial neuropathies following clival infarction. Neurology. 2019 Sep 3；93(10)：e1031.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2000893, encodeId=562c2000893b3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Tue Sep 15 04:00:00 CST 2020, time=2020-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374349, encodeId=656d3e434903, content=少见, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/AiafG5m7kibldQyTnpaQicxg1rnBqFdIGgQBJJs4lR8ibmh91PibzgL7R7pl2HSBjgFeeKRV0mMCvDh49LrgJPCYYvA/132, createdBy=abc91707732, createdName=qjzhai1623, createdTime=Thu Oct 24 22:48:51 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374321, encodeId=30033e43218a, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Thu Oct 24 06:49:58 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374320, encodeId=d0803e43208c, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, 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=Thu Oct 24 06:47:16 CST 2019, time=2019-10-24, status=1, ipAttribution=)]
    2020-09-15 yinhl1978

    #Neurol#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2000893, encodeId=562c2000893b3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Tue Sep 15 04:00:00 CST 2020, time=2020-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374349, encodeId=656d3e434903, content=少见, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/AiafG5m7kibldQyTnpaQicxg1rnBqFdIGgQBJJs4lR8ibmh91PibzgL7R7pl2HSBjgFeeKRV0mMCvDh49LrgJPCYYvA/132, createdBy=abc91707732, createdName=qjzhai1623, createdTime=Thu Oct 24 22:48:51 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374321, encodeId=30033e43218a, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Thu Oct 24 06:49:58 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374320, encodeId=d0803e43208c, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, 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=Thu Oct 24 06:47:16 CST 2019, time=2019-10-24, status=1, ipAttribution=)]
    2019-10-24 qjzhai1623

    少见

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2000893, encodeId=562c2000893b3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Tue Sep 15 04:00:00 CST 2020, time=2020-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374349, encodeId=656d3e434903, content=少见, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/AiafG5m7kibldQyTnpaQicxg1rnBqFdIGgQBJJs4lR8ibmh91PibzgL7R7pl2HSBjgFeeKRV0mMCvDh49LrgJPCYYvA/132, createdBy=abc91707732, createdName=qjzhai1623, createdTime=Thu Oct 24 22:48:51 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374321, encodeId=30033e43218a, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Thu Oct 24 06:49:58 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374320, encodeId=d0803e43208c, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, 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=Thu Oct 24 06:47:16 CST 2019, time=2019-10-24, status=1, ipAttribution=)]
    2019-10-24 1e1c07bdm01(暂无匿称)

    好

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2000893, encodeId=562c2000893b3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Tue Sep 15 04:00:00 CST 2020, time=2020-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374349, encodeId=656d3e434903, content=少见, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/AiafG5m7kibldQyTnpaQicxg1rnBqFdIGgQBJJs4lR8ibmh91PibzgL7R7pl2HSBjgFeeKRV0mMCvDh49LrgJPCYYvA/132, createdBy=abc91707732, createdName=qjzhai1623, createdTime=Thu Oct 24 22:48:51 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374321, encodeId=30033e43218a, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Thu Oct 24 06:49:58 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374320, encodeId=d0803e43208c, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, 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=Thu Oct 24 06:47:16 CST 2019, time=2019-10-24, status=1, ipAttribution=)]
    2019-10-24 深海的鱼

    学习学习学习

    0