46例神经梅毒临床特征及影像学特点

发布时间：2017-12-28 11:18

本文关键词：46例神经梅毒临床特征及影像学特点　出处：《中华实验和临床感染病杂志(电子版)》2016年05期 　论文类型：期刊论文

【摘要】：目的探讨神经梅毒患者临床特征及影像学特点。方法回顾性总结2014年2月至2015年8月于首都医科大学附属北京地坛医院神经内科确诊的46例神经梅毒患者的临床特征及影像学特点。结果 46例神经梅毒患者中男性33例,女性13例。平均年龄(50.00±10.78)岁。分为4组:无症状型神经梅毒8例(8/46,17.4%),头颅磁共振检查均未见异常。间质型神经梅毒9例(9/46,19.6%),头颅磁共振检查正常2例,急性或陈旧性梗死灶4例,颅内多发皮层异常信号2例,脑膜增强1例。脑实质型神经梅毒28例(28/46,60.9%),头颅磁共振检查正常9例,脑萎缩13例,脑积水1例,侧脑室旁缺血灶5例;2例脊髓痨患者头颅及腰椎磁共振检查均正常。梅毒性树胶肿1例(1/46,2.2%),头颅磁共振检查示右侧额叶及右侧小脑结节样强化灶,伴周围水肿。驱梅治疗后复查头颅磁共振检查正常。结论神经梅毒表现多样,影像学多变,临床中需将梅毒血清学化验作为常规检查以减少误诊几率。
[Abstract]:Objective to study the clinical features and imaging characteristics of patients with neurosyphilis. Methods to retrospectively summarize the clinical features and imaging from February 2014 to August 2015 in the Capital Medical University affiliated Beijing Ditan Hospital of Neurology confirmed 46 cases of patients with neurosyphilis features. Results 46 cases of neurosyphilis in male 33 cases, female 13 cases. The average age was (50 + 10.78) years. Divided into 4 groups: asymptomatic neurosyphilis in 8 cases (8/46,17.4%), MRI examination showed no abnormality. 9 cases of interstitial neurosyphilis (9/46,19.6%), magnetic resonance imaging of the brain was normal in 2 cases, 4 cases of acute or chronic cerebral infarction, 2 patients with multiple intracranial abnormal cortical signals, meningeal enhancement in 1 cases. Cerebral parenchyma type 28 cases of neurosyphilis (28/46,60.9%), magnetic resonance imaging of the brain was normal in 9 cases, 13 cases of cerebral atrophy, 1 cases of hydrocephalus, 5 cases of periventricular ischemic lesions; 2 cases of spinal tuberculosis patients with skull and lumbar MRI were normal. 1 cases of syphilitic gumma (1/46,2.2%). The cranial magnetic resonance imaging showed the right frontal lobe and right cerebellar nodular fortified foci with peripheral edema. After the treatment, the MRI examination was normal. Conclusion neurosyphilis manifestation, imaging in the clinical and serologic tests as a routine examination in order to reduce the misdiagnosis rate.
【作者单位】：首都医科大学附属北京地坛医院神经内科;
【分类号】：R759.13
【正文快照】： 神经梅毒是苍白密螺旋体侵入中枢神经系统,引起脑膜、血管、脑及脊髓等部位病变。其临床表现多样,可表现为视力下降、精神症状、肢体无力、发热抽搐、癫痫以及帕金森症状。根据其临床表现及侵犯部位可分为无症状型神经梅毒、间质型(脑膜和血管型)神经梅毒、脑实质型神经梅毒(

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