Baidu
map

神经科

订阅

MedSci主页 / 所有栏目 / 神经科

NEJM：壳核海绵状血管瘤致对侧难治性偏侧舞蹈症一例

2013-05-20 NEJM dxy

NEJM壳核海绵状血管瘤偏侧舞蹈症
关注

患者，男，65岁，左手不自主运动10余年。神经系统检查显示左手臂偏侧舞蹈，睡眠时症状消失。颅脑CT检查显示右侧壳核处有一钙化灶。脑MRI检查T2加权相显示右侧壳核混杂信号，病灶中心呈低信号，伴周边低信号环，MRI提示海绵状血管瘤。MRA血管检查未见异常。口服氟哌啶醇、丙戊酸钠及唑尼沙胺等治疗，症状未见改善。各类脑血管病往往影响基底节区，从而有时会出现病灶对侧偏侧舞蹈症，但是症状往往是短暂的。壳核海

患者，男，65岁，左手不自主运动10余年。神经系统检查显示左手臂偏侧舞蹈，睡眠时症状消失。颅脑CT检查显示右侧壳核处有一钙化灶。脑MRI检查T2加权相显示右侧壳核混杂信号，病灶中心呈低信号，伴周边低信号环，MRI提示海绵状血管瘤。MRA血管检查未见异常。口服氟哌啶醇、丙戊酸钠及唑尼沙胺等治疗，症状未见改善。各类脑血管病往往影响基底节区，从而有时会出现病灶对侧偏侧舞蹈症，但是症状往往是短暂的。壳核海绵状血管瘤，偏侧舞蹈症的罕见病因，往往造成难治性脑皮质运动区与基底节区的信号环路异常。

Images in clinical medicine. Persistent hemichorea.

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2007141, encodeId=603a200e141ee, content=<a href='/topic/show?id=e80b8661eec' target=_blank style='color:#2F92EE;'>#舞蹈症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86617, encryptionId=e80b8661eec, topicName=舞蹈症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Tue Nov 05 19:34:00 CST 2013, time=2013-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1348239, encodeId=4deb134823962, content=<a href='/topic/show?id=1eaf89e26d3' target=_blank style='color:#2F92EE;'>#血管瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89726, encryptionId=1eaf89e26d3, topicName=血管瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528249, encodeId=3781152824986, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551034, encodeId=f64c1551034ad, content=<a href='/topic/show?id=04886565ee9' target=_blank style='color:#2F92EE;'>#海绵状血管瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65657, encryptionId=04886565ee9, topicName=海绵状血管瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0ba14160863, createdName=lvliquan, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1591759, encodeId=84851591e590a, content=<a href='/topic/show?id=3047656523d' target=_blank style='color:#2F92EE;'>#海绵状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65652, encryptionId=3047656523d, topicName=海绵状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=223518012442, createdName=cooco, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=)]
    2013-11-05 12498dabm77暂无昵称

    #舞蹈症#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2007141, encodeId=603a200e141ee, content=<a href='/topic/show?id=e80b8661eec' target=_blank style='color:#2F92EE;'>#舞蹈症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86617, encryptionId=e80b8661eec, topicName=舞蹈症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Tue Nov 05 19:34:00 CST 2013, time=2013-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1348239, encodeId=4deb134823962, content=<a href='/topic/show?id=1eaf89e26d3' target=_blank style='color:#2F92EE;'>#血管瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89726, encryptionId=1eaf89e26d3, topicName=血管瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528249, encodeId=3781152824986, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551034, encodeId=f64c1551034ad, content=<a href='/topic/show?id=04886565ee9' target=_blank style='color:#2F92EE;'>#海绵状血管瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65657, encryptionId=04886565ee9, topicName=海绵状血管瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0ba14160863, createdName=lvliquan, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1591759, encodeId=84851591e590a, content=<a href='/topic/show?id=3047656523d' target=_blank style='color:#2F92EE;'>#海绵状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65652, encryptionId=3047656523d, topicName=海绵状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=223518012442, createdName=cooco, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=)]
    2013-05-22 clmlylxy

    #血管瘤#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2007141, encodeId=603a200e141ee, content=<a href='/topic/show?id=e80b8661eec' target=_blank style='color:#2F92EE;'>#舞蹈症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86617, encryptionId=e80b8661eec, topicName=舞蹈症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Tue Nov 05 19:34:00 CST 2013, time=2013-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1348239, encodeId=4deb134823962, content=<a href='/topic/show?id=1eaf89e26d3' target=_blank style='color:#2F92EE;'>#血管瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89726, encryptionId=1eaf89e26d3, topicName=血管瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528249, encodeId=3781152824986, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551034, encodeId=f64c1551034ad, content=<a href='/topic/show?id=04886565ee9' target=_blank style='color:#2F92EE;'>#海绵状血管瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65657, encryptionId=04886565ee9, topicName=海绵状血管瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0ba14160863, createdName=lvliquan, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1591759, encodeId=84851591e590a, content=<a href='/topic/show?id=3047656523d' target=_blank style='color:#2F92EE;'>#海绵状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65652, encryptionId=3047656523d, topicName=海绵状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=223518012442, createdName=cooco, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=)]
    2013-05-22 freve

    #难治性#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2007141, encodeId=603a200e141ee, content=<a href='/topic/show?id=e80b8661eec' target=_blank style='color:#2F92EE;'>#舞蹈症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86617, encryptionId=e80b8661eec, topicName=舞蹈症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Tue Nov 05 19:34:00 CST 2013, time=2013-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1348239, encodeId=4deb134823962, content=<a href='/topic/show?id=1eaf89e26d3' target=_blank style='color:#2F92EE;'>#血管瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89726, encryptionId=1eaf89e26d3, topicName=血管瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528249, encodeId=3781152824986, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551034, encodeId=f64c1551034ad, content=<a href='/topic/show?id=04886565ee9' target=_blank style='color:#2F92EE;'>#海绵状血管瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65657, encryptionId=04886565ee9, topicName=海绵状血管瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0ba14160863, createdName=lvliquan, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1591759, encodeId=84851591e590a, content=<a href='/topic/show?id=3047656523d' target=_blank style='color:#2F92EE;'>#海绵状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65652, encryptionId=3047656523d, topicName=海绵状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=223518012442, createdName=cooco, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=)]
    2013-05-22 lvliquan

    #海绵状血管瘤#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2007141, encodeId=603a200e141ee, content=<a href='/topic/show?id=e80b8661eec' target=_blank style='color:#2F92EE;'>#舞蹈症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86617, encryptionId=e80b8661eec, topicName=舞蹈症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Tue Nov 05 19:34:00 CST 2013, time=2013-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1348239, encodeId=4deb134823962, content=<a href='/topic/show?id=1eaf89e26d3' target=_blank style='color:#2F92EE;'>#血管瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89726, encryptionId=1eaf89e26d3, topicName=血管瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528249, encodeId=3781152824986, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551034, encodeId=f64c1551034ad, content=<a href='/topic/show?id=04886565ee9' target=_blank style='color:#2F92EE;'>#海绵状血管瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65657, encryptionId=04886565ee9, topicName=海绵状血管瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0ba14160863, createdName=lvliquan, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1591759, encodeId=84851591e590a, content=<a href='/topic/show?id=3047656523d' target=_blank style='color:#2F92EE;'>#海绵状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65652, encryptionId=3047656523d, topicName=海绵状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=223518012442, createdName=cooco, createdTime=Wed May 22 07:34:00 CST 2013, time=2013-05-22, status=1, ipAttribution=)]
    2013-05-22 cooco

    #海绵状#

    0

相关资讯

NEJM：阿比特龙可使早期前列腺癌患者有显著获益

一项重要的新临床试验显示，一种已经用于治疗晚期前列腺癌的药物也可使早期前列腺癌患者明显获益。去年5月英国国家卫生与临床优化研究所（NICE）批准将伦敦癌症研究所研制的阿比特龙列为国家健康保险（NHS）的医保用药，其治疗适应症是对标准激素治疗和紫杉醇化疗停止反应的前列腺癌。 癌症研究所（ICR）和皇家马斯登NHS信托基金进行了一项新的III期临床试验，结果显示，化疗前给无症状和轻度症状男性患者进行

NEJM：预防性血小板输注可减少血液系统肿瘤出血事件

对于血液系统肿瘤疾病患者人群，血小板输注防止出血的有效性尚不清楚。英国牛津大学医院国民健康服务（NHS）基金会约翰·拉德克利夫医院NHS血液和移植部的Stanworth博士等人进行的该项试验评估了不给予预防性血小板输注的策略是否与提供预防性血小板输注策略同样有效和安全。他们发现，研究结果支持继续使用预防性血小板输注的需求，并且结果显示与无预防策略相比这类预防有减少出血的益处。即使使用预防策略仍有大

NEJM: 乳腺癌放疗增加缺血性心脏病风险

缺血性心脏病的累积发生率 乳腺癌放疗往往涉及一些偶然的心脏对电离辐射的暴露。这种暴露对以后缺血性心脏病风险的影响尚不确定。英国牛津大学Darby博士及其同事对此进行了深入研究，他们发现在乳腺癌放疗期间心脏电离辐射暴露可导致以后缺血性心脏病的发生率增加。该病发生率的增加与心脏受照平均剂量成比例，于暴露后数年内开始，并持续至少20年。此前存在心脏风险因素的女性因放疗导致的风险绝对增加值大于其他女

NEJM：自噬、疾病及临床应用

自噬与癌症自噬现象可能对癌症的发生和发展以及对这种疾病治疗干预的效果产生多重因素的影响。在大约40%～75%的人类乳腺、卵巢和前列腺肿瘤患者人群中，位于染色体17q21上的BECN1单等位基因发生重排。临床研究显示，预后差与肿瘤组织中存在Beclin1异常表达及侵袭性表型相关。人类癌症标本中的研究发现其他自噬蛋白表达也存在改变（例如在前列腺癌中ATG5表达上调）。此外，一些自噬基因的染色体畸变在人

NEJM：磁共振随访检查对坐骨神经痛患者无益

存在已知腰椎间盘突出症和持续存在坐骨神经痛症状的患者在随访期间经常进行磁共振成像（MRI）检查。目前对MRI的表现与临床转归之间的相关性尚存争议。荷兰莱顿大学医学中心神经外科的Abdelilah Barzouhi博士等人进入了深入研究，他们发现，已治疗坐骨神经痛和腰椎间盘突出症的患者随访1年时进行的MRI检查在转归良好的患者与转归欠佳的患者之间无差异。研究结果发表于国际权威杂志NEJM 2013年

NEJM：Omega-3鱼油不能预防心血管疾病

日前，一项大型研究结果显示，富含Omega-3脂肪酸的鱼油补充剂，对心血管疾病高风险患者可能并没有帮助。该报告发表在了5月9日出版的《新英格兰医学杂志》（New England Journal of Medicine）上。在2010年，意大利的研究人员开展了这项研究，他们把12513名病人分成两组，一组服用Omega-3补充剂，另一组服用橄榄油安慰剂。以前的临床试验表明，对于心血管疾病患者或曾经历

Baidu
map
Baidu
map
Baidu
map