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題 名 | 高血壓性腦病變的醫學影像=Imaging of Hypertensive Encephalopathy |
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作 者 | 沈戊忠; 陳昭安; 詹益豐; | 書刊名 | 中國醫藥學院雜誌 |
卷 期 | 6:2 1997.09[民86.09] |
頁 次 | 頁115-119 |
分類號 | 415.92 |
關鍵詞 | 高血壓性腦病變; 電腦斷層攝影; 磁振造影; Hypertensive encephalopathy; Magnetic resonance imaing; Computed tomography; |
語 文 | 中文(Chinese) |
中文摘要 | 高血壓性腦病變乃因血壓突然升高所引起的神經性症狀。高血壓性腦病變在腦內 有特殊的發生位置,主要發生在大腦枕葉,而且都是雙側同時發生,很容易可被電腦斷層攝 影 (CT) 及磁振造影 (MRI) 偵測出來。在此我們提出二例高血壓性腦病變的 CT 及 MRI 的 影像。病例一是位十七歲男孩,本來就患有 anaphylactoid purpura。發病前三天開始有血 壓上昇現象,後來突然發生視力模糊,劇烈頭痛,頭部 CT 顯示雙側枕葉有明顯的腦水腫。 病例二也是一位十七歲男孩,本來就患有慢性腎衰竭,發病前三天開始有血壓上昇現象,並 且表現如病例一之症狀,MRI 顯示雙側枕葉,胼肢體壓部,扣帶回都有急性腦組織水腫,及 合併一些出血。此二病例經正確診斷予以降低血壓後三天,視力都恢復正常。 |
英文摘要 | Hypertensive encephalopathy is a particular syndrome caused by sudden elevation of systemic blood pressure. It is characterized by rapidly progressive signs and symptoms, including headache, seizures, visual disturbance, altered mental status, and focal neurologic signs. The CT and MRI can detect lesions in bilateral occipital lobes, which are acute brain tissue edema, sometimes associated with hemorrhage. Here, we report 2 cases of hypertensive encephalopathy, both were 17-year-old boys, one had underlying disease of anaphylactoid purpura, sudden onset of severe headache and vision loss 3 days after persistent elevation of blood pressure. Ct disclosed acute brain tissue edema in bilateral occipital lobes. Another case had underlying disease of chronic renal failure, developed vision loss, severe headache and dizziness after 3 days of elevation of systemic blood pressure. MRI showed acute brain tissue edema mixed with some hemorrhage in the bilateral occipital lobes, splenium of corpus callosum and cingulum. The clinical symptoms disappeared after the blood pressure was corrected to normal range. The brain normally is protected by an autoregulation system that ensures constant perfusion over a range of systemic pressures. If these autoregulatory limits are exceeded, passive overdistention of cerebral arterioles may occur and blood-brain barrier breakdown ensues. Interstitial extravasation of proteins and fluid results in multiple foci of reversible vasogenic edema. Why the posterior circulation is particularly prone to develop hypertensive encephalopathy ﹖ A theory was postulated that the internal carotid system is much better spullied with sympathetic innervation than the vertebrobasilar system, so the autoregulation ability in the posterior circulation is always not enough in the occipital lobes in a situation of sudden elevation of high blood pressure. |
本系統中英文摘要資訊取自各篇刊載內容。