全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
-  2018 

颅咽管瘤术后并发尾状核、壳核、皮质下脱髓鞘1例报告并文献复习 Postoperative Caudal Putamen,Putamen and Subcortical Demyelination After Craniopharyngioma Surgery:One Cases Report and Literature Review

Keywords: 颅咽管瘤,电解质,脱髓鞘

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的:报告1例颅咽管瘤术后并发尾状核、壳核、皮质下脱髓鞘病例并文献复习。方法:根据患者病史、临床表现、神经影像学检查和生化指标结果,分析患者颅咽管瘤术后发生脑组织脱髓鞘的诊治情况,总结临床特点。结果:1例女性患儿,9岁,病程6个月。神经体征检查阴性,内分泌功能正常。头颅CT及MRI发现鞍区占位,诊断为"颅咽管瘤",开颅行颅咽管瘤切除术。术后第6天出现电解质紊乱,血Na+波动在123-143mmol/L,出现肢体抽搐,右侧肢体肌力降低,Ⅲ-Ⅳ级,其余肢体肌力正常。头颅MRI检查发现左侧尾状核、壳核、皮质下脱髓鞘。给予营养神经、水电解质平衡等治疗,患者病情恢复正常。术后1月复查头颅MRI,脱髓鞘病灶未见进展。患儿无明显神经功能障碍,生活可自理。结论:颅咽管瘤术后电解质紊乱引起的脑组织脱髓鞘改变,临床少见,具有一定特征性。早期诊断依赖于血钠水平、头颅MRI及患者的神经体征变化

References

[1]  Samii M,Tatagiba M.Surgical management of craniopharygiomas:A review[J].Neuro Med Chir(Tokyo),1991,37:141-149.
[2]  漆松涛,陈状,方陆雄,等.颅咽管瘤全切除术后钠代谢紊乱及处理[J].中国临床神经外科杂志,2004,9(3):173-175.Qi ST,Chen Z,Fang LX,et al.Sodium disorder and treatment following total resection of craniopharyngioma[J].Chin J Clin Neurosurg,2004,9(3):173-175.
[3]  Wilson JD,Foster DW,Kronenberg HM,et al.Williams textbook of endocrinology[M].9th Ed.USA:Harcourt Publishers Limited,1998:1 509-1 531.
[4]  Robert L,Barbara K.Pontine andextrapontine myelinolysis following rapid correction of hyponatraemia[J].The Lancet,1988,1:1 439-1 441.
[5]  Raisz LG,Mcneely WF,Saxon L,et al.The effects of cortisone and hydrocortisone on water diuresis and renal function in man[J].J Clin Invest,1957,36(6Part1):767-779.
[6]  Tien R,Arirff A,Kuchaeczyk W,et al.Hyponatremic encephalopathy:Is central pontine myelinolylsis a component[J]?Am J Med,1992,92:513-522.
[7]  Kleinschmidt-DeMasters BK,Norenberg MD.Rapid correction of hyponatremia causes demyelination:Relation to central pontine myelinolysis[J].Science,1981,211:1 068-1 070.
[8]  Gocht A,Colmant HJ.Central pontine and extrapontine myelinolysis:a report of 58cases[J].Clin Neuropathol,1987,6(6):262-270.
[9]  Ruzek KA,Campeau NG,Miller GM.Early diagnosis of central pontine myelinolysis with diffusion-weighted imaging[J].AJNR Am J Neuroradiol,2004,25(2):210-213.
[10]  Tosaka M,Kohga H.Extrapontine myelinolysis and behavioral change after transssphenoidal pituitary surgery:Case report[J].Neurosurg,1998,43:9 330-9 336.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133