脑血管介入治疗所致造影剂脑病临床特点分析
作者:
作者单位:

1.湖南中医药大学临床医学院,湖南 长沙 410208;2.湖南省脑科医院(湖南省第二人民医院),湖南 长沙 410021

作者简介:

彭怡(1996―),女,在读研究生,执业医师,主要从事脑血管病研究。Email:py15927733163@163.com。

通信作者:

黄晓松(1971―),男,博士,主任医师,主要从事脑血管病研究。Email:Huangxs-0819@163.com。

基金项目:


Clinical features of contrast-induced encephalopathy caused by cerebrovascular intervention therapy
Author:
Affiliation:

1.Clinical Medicine School, Hunan University of Traditional Chinese Medicine, Changsha, Hunan 410208, China;2.Hunan Provincial Brain Hospital (Hunan Second People's Hospital), Changsha, Hunan 410021, China

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    摘要:

    造影剂脑病(contrast-induced encephalopathy, CIE)是一种罕见的急性且可逆的神经系统疾病,与动脉内注射碘化造影剂有关。该文收集了湖南省脑科医院进行脑血管介入术后出现的3例CIE患者。3例CIE患者中,2例出现精神症状,1例神志改变;3例患者均出现肢体乏力,1例肢体抽搐。3例影像学提示有新增梗死灶,1例有造影剂渗出,1例脑出血增多。对症治疗后,2例患者基本好转,1例患者有肢体无力后遗症。文献回顾发现,脑血管介入术后CIE的临床表现有精神行为异常、视力下降、偏瘫、失语等;影像学表现可能出现脑水肿、新发脑梗死、蛛网膜下腔高密度影和高信号影等,部分患者影像学无异常。经对症治疗后,大部分患者症状完全消失,少数患者有后遗症。

    Abstract:

    Contrast-induced encephalopathy (CIE) is a rare, acute, and reversible nervous system disease and is associated with the intra-arterial injection of iodized contrast agents. This article retrospectively analyzes three patients who developed CIE after cerebrovascular intervention in Hunan Province Brain Hospital. Among the three patients, two had mental symptoms and one had altered consciousness; all three patients had limb weakness, and one had limb convulsions. Radiological examination suggested new-onset infarcts in three patients, contrast agent extravasation in one patient, and an increase in cerebral hemorrhage in one patient. After symptomatic treatment, two patients were improved and one patient had the sequela of limb weakness. Literature review showed that the clinical manifestations of CIE after cerebrovascular intervention included mental and behavioral disorders, impaired vision, hemiplegia, and aphasia, and imaging findings may include brain edema, new-onset cerebral infarction, and high-density and hyperintensity shadows in the subarachnoid space, while some patients may have no imaging abnormalities. Symptoms completely disappear in most patients after symptomatic treatment, while a few patients may have sequelae.

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彭怡,黄晓松,杨叶,杨莹,刘柳青456.脑血管介入治疗所致造影剂脑病临床特点分析[J].国际神经病学神经外科学杂志,2023,50(5):64-68111PENG Yi, HUANG Xiaosong, YANG Ye, YANG Ying, LIU Liuqing222. Clinical features of contrast-induced encephalopathy caused by cerebrovascular intervention therapy[J]. Journal of International Neurology and Neurosurgery,2023,50(5):64-68

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  • 收稿日期:2023-03-02
  • 最后修改日期:2023-08-27
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  • 在线发布日期: 2023-11-30
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