重症监护室一名儿科病人的后可逆性脑炎综合征(PRES)

C. Mata-Perera, JM López-Álvarez, DL Lorenzo-Villegas
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引用次数: 0

摘要

后可逆性脑病综合征(PRES)是近年来日益受到重视的一种疾病。其诊断方法是临床放射学诊断。临床上,患者会出现头痛、意识减退、癫痫发作和视力障碍等神经系统改变。在放射学上,它包括脑水肿,在磁共振成像中主要表现为顶枕部白质水肿。多种情况都可能诱发这种疾病,包括高血压、免疫抑制剂、类固醇和化疗等众所周知的危险因素。为避免这些患者出现后遗症,早期诊断和适当治疗至关重要。本病例中的患者在 11 岁时被诊断出患有脑部双灶性非革兰氏肿瘤,在接受化疗治疗后,他的病情出现临床恶化,并伴有脓毒性休克的不稳定性。随后,他的意识水平突然改变,并伴有高血压和肾功能衰竭。
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Posterior Reversible Encephalitis Syndrome (PRES) in a paediatric patient in the intensive care unit
Posterior Reversible Encephalopathy Syndrome (PRES) is an entity that has gained importance in recent years. The diagnosis is clinical-radiological. Clinically, the patient presents neurological alterations such as headache, decreased level of consciousness, seizures, and visual disturbances. Radiologically, it includes cerebral oedema, predominantly of the white matter of parietal-occipital regions on magnetic resonance imaging. Multiple situations can trigger this condition, including high blood pressure, immunosuppressants, steroids, and chemotherapy well-known risk factors. An early diagnosis and adequate treatment are essential to avoid the appearance of sequelae in these patients. This case consists of a patient diagnosed at 11 years of age with a bifocal non-germline tumour in the brain who, after treatment with chemotherapy, presented a clinical deterioration with instability compatible with septic shock. Subsequently, he presented a sudden alteration in the level of consciousness accompanied by hypertension and renal failure, which was suspected of PRES after a brain CT imaging test.
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