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与大叶性肺炎相关的可逆性胼胝体病变综合征:病例报告及文献复习

Reversible splenial lesion syndrome associated with lobar pneumonia: Case report and review of literature.

作者信息

Li Chunrong, Wu Xiujuan, Qi Hehe, Cheng Yanwei, Zhang Bing, Zhou Hongwei, Lv Xiaohong, Liu Kangding, Zhang Hong-Liang

机构信息

aNeuroscience Center, Department of Neurology bDepartment of Radiology, the First Hospital of Jilin University, Jilin University, Changchun, China.

出版信息

Medicine (Baltimore). 2016 Sep;95(39):e4798. doi: 10.1097/MD.0000000000004798.

Abstract

BACKGROUND

Reversible splenial lesion syndrome (RESLES) is a rare clinico-radiological disorder with unclear pathophysiology. Clinically, RESLES is defined as reversible isolated splenial lesions in the corpus callosum, which can be readily identified by magnetic resonance imaging (MRI) and usually resolve completely over a period of time. RESLES could be typically triggered by infection, antiepileptic drugs (AEDs), poisoning, etc. More factors are increasingly recognized.

METHODS AND RESULTS

We reported herein an 18-year-old female patient with lobar pneumonia who developed mental abnormalities during hospitalization. An isolated splenial lesion in the corpus callosum was found by head MRI and the lesion disappeared 15 days later. Based on her clinical manifestations and radiological findings, she was diagnosed with lobar pneumonia associated RESLES. We further summarize the up-to-date knowledge about the etiology, possible pathogenesis, clinical manifestations, radiological features, treatment, and prognosis of RESLES.

CONCLUSION

This report contributes to the clinical understanding of RESLES which may present with mental abnormalities after infection. The characteristic imaging of reversible isolated splenial lesions in the corpus callosum was confirmed in this report. The clinical manifestations and lesions on MRI could disappear naturally after 1 month without special treatment.

摘要

背景

可逆性胼胝体压部病变综合征(RESLES)是一种罕见的临床放射学疾病,其病理生理学尚不清楚。临床上,RESLES被定义为胼胝体中可逆的孤立性病变,可通过磁共振成像(MRI)轻易识别,且通常在一段时间内完全消退。RESLES通常可由感染、抗癫痫药物(AEDs)、中毒等引发。越来越多的因素被认识到。

方法与结果

我们在此报告一名18岁患有大叶性肺炎的女性患者,其在住院期间出现精神异常。头部MRI发现胼胝体有一个孤立性病变,15天后该病变消失。根据其临床表现和影像学检查结果,她被诊断为与大叶性肺炎相关的RESLES。我们进一步总结了关于RESLES的病因、可能的发病机制、临床表现、影像学特征、治疗及预后的最新知识。

结论

本报告有助于临床对RESLES的理解,RESLES可能在感染后出现精神异常。本报告证实了胼胝体中可逆性孤立性病变的特征性影像学表现。MRI上的临床表现和病变在未经特殊治疗的情况下1个月后可自然消失。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12c2/5265898/4b09aa98271f/medi-95-e4798-g001.jpg

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